Cervantes, Stacey

Cervantes, Stacey is an individual health care provider with primary practice located at 1140 Sw Bascom Norris Dr Ste 104 , Lake City FL 32025-1329. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Cervantes, Stacey can be contacted via phone (386) 719-6500.

Contact Information

Primary practice address
1140 Sw Bascom Norris Dr Ste 104 Lake City FL 32025-1329
Phone: (386) 719-6500
Fax: (386) 719-6503
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1477082 Florida

Profile Details

NPI number 1629077144
LBN Legal business name Cervantes, Stacey
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Oct 10th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629077144 NPPES
Florida MEDICAID 308846400

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