Individual
DR. JESSICA LEIGH STALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1007 W COMMERCIAL BLVD, FT LAUDERDALE, FL 33309-3107
(954) 564-2592
(954) 564-2705
Mailing address
1007 W COMMERCIAL BLVD, FT LAUDERDALE, FL 33309-3107
(954) 564-2592
(954) 564-2705
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
25MB10183900
NJ
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
OS16365
FL
Other
Enumeration date
04/20/2015
Last updated
05/28/2020
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