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:
Health care specialties
Specialty | Code | License # | 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 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1548435365 | NPPES |
Florida | MEDICAID | 000235600 | |
Florida | Other | 91683 |
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