Kaciuban, Stacey

Kaciuban, Stacey is an sole proprietor health care provider with primary practice located at 1600 S Andrews Ave Emergency Department, Fort Lauderdale FL 33316-2510. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Kaciuban, Stacey can be contacted via phone (954) 355-4400.

Contact Information

Primary practice address
1600 S Andrews Ave Emergency Department Fort Lauderdale FL 33316-2510
Phone: (954) 355-4400
Fax: (954) 468-8035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME102063 Florida

Profile Details

NPI number 1548435365
LBN Legal business name Kaciuban, Stacey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2008
Last updated Nov 18th, 2009 - about 17 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 1548435365 NPPES
Florida MEDICAID 000235600
Florida Other 91683

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