MEDICARE: CARMI Y STADLAN, M.D. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME69654	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	Q0054	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740236165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARMI Y STADLAN, M.D. P.A.

Provider Business Mailing Address
First Line	:	122A JFK DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-6606
Country	:	US
Telephone Number	:	561-969-3795
Fax Number	:	561-969-3771

Provider Business Practice Location Address
First Line	:	122A JFK DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-6606
Country	:	US
Telephone Number	:	561-969-3795
Fax Number	:	561-969-3771

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARMI Y STADLAN
Credential	:	MD
Telephone Number	:	561-969-3795

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/03/2015

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