Mcdonald, Stacey Lee

Mcdonald, Stacey Lee is an individual health care provider with primary practice located at 36 Eglin Pkwy Ne , Fort Walton Beach FL 32548-4915. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Mcdonald, Stacey Lee can be contacted via phone (850) 243-3111.

Contact Information

Primary practice address
36 Eglin Pkwy Ne Fort Walton Beach FL 32548-4915
Phone: (850) 243-3111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3363 Florida

Profile Details

NPI number 1518927052
LBN Legal business name Mcdonald, Stacey Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Mar 24th, 2022 - about 2 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 1518927052 NPPES
Florida MEDICAID 112657200

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