Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2305210066 | VA |
Y | 225100000X | Physical Therapist | PT 32357 | FL |
NPI | 1003275967 |
---|---|
Provider Name | Janeil L. Stehr |
First Address | Miami Beach, FL 33141-2972 |
Second Address | Miami Beach, FL 33141-2972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2016 |
Last Update Date | 10/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003275967 | MEDICAID QMB ONLY (01) | FL |
1003275967 | MEDICAID QMB ONLY (01) | VA |
C05954 | MEDICARE GROUP PTAN (01) | FL |
C05954 | MEDICARE GROUP PTAN (01) | VA |