Lacey, Stephanie Regan

Lacey, Stephanie Regan is an individual health care provider with primary practice located at 841 Prudential Dr Ufjp Pediatric Cardiology, Jacksonville FL 32207-8329. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is her primary health care specialty. Lacey, Stephanie Regan can be contacted via phone (904) 493-1610.

Contact Information

Primary practice address
841 Prudential Dr Ufjp Pediatric Cardiology Jacksonville FL 32207-8329
Phone: (904) 493-1610
Fax: (904) 493-2363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OS9818 Florida
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X OS9818 Florida

Profile Details

NPI number 1992741342
LBN Legal business name Lacey, Stephanie Regan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Apr 23rd, 2010 - about 16 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 1992741342 NPPES
Florida MEDICAID 2759861-00
Florida MEDICAID 109704014A
Florida MEDICAID 275986100

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