Poole, Stacia

Poole, Stacia is an individual health care provider with primary practice located at 930S Harbor City Blvd 101 , Melbourne FL 32901-1901. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Poole, Stacia can be contacted via phone (321) 752-1599.

Contact Information

Primary practice address
930S Harbor City Blvd 101 Melbourne FL 32901-1901
Phone: (321) 752-1599
Fax: (321) 956-9907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME51873 Florida

Profile Details

NPI number 1598732471
LBN Legal business name Poole, Stacia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Dec 29th, 2015 - about 10 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 1598732471 NPPES
Other 070007530 RAIL ROAD MEDICARE
MEDICAID 373042500 RAIL ROAD MEDICARE

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