Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME79521 | FL |
N | 208600000X | Surgeon | ME79521 | FL |
Y | 2086S0102X | Surgical Critical Care | ME79521 | FL |
N | 2086S0127X | Trauma Surgeon | ME79521 | FL |
N | 208G00000X | Cardiothoracic Vascular Surgeon | ME79521 | FL |
NPI | 1043460488 |
---|---|
Provider Name | Kenneth P Stahl |
First Address | Miami, FL 33136-1005 |
Second Address | Miami, FL 33136-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2008 |
Last Update Date | 26/10/2016 |