Individual ProviderJustin Philip StanziolaStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607(843) 692-3499PECOS EnrollmentBased on the most recent information from CMS, provider Justin Philip Stanziola does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:05 AM.Profile DetailsProvider ID1124829205Provider TypeIndividualFull NameStanziola, Justin PhilipTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/24/2025Last Updated3/24/2025Contact InformationPractice LocationPractice Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607Phone(843) 692-3499FaxUnlisted FaxMailing LocationMailing Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607Phone(843) 692-3499FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer