Individual
KENNETH P STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, BOX 016960, MIAMI, FL 33136-1005
(305) 585-1288
(305) 585-1020
Mailing address
1611 NW 12TH AVE, BOX 016960, MIAMI, FL 33136-1005
(305) 585-1288
(305) 585-1020
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME79521
FL
2086S0102X
Surgical Critical Care Physician
Primary
ME79521
FL
2086S0127X
Trauma Surgery Physician
ME79521
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME79521
FL
Other
Enumeration date
09/23/2008
Last updated
10/26/2016
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