Provider Demographics
NPI:1174764401
Name:STELLER LIFE CARE
Entity type:Organization
Organization Name:STELLER LIFE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:STELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-520-1818
Mailing Address - Street 1:PO BOX 2721
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-2721
Mailing Address - Country:US
Mailing Address - Phone:727-734-7611
Mailing Address - Fax:727-736-1124
Practice Address - Street 1:3500 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-1448
Practice Address - Country:US
Practice Address - Phone:727-520-1818
Practice Address - Fax:727-520-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty