Individual
SUZANNE E STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
2040 SHORT AVE, SUITE 100, ODESSA, FL 33556-3445
(727) 372-9922
(727) 372-8477
Mailing address
3629 MCCLOUD ST, NEW PORT RICHEY, FL 34655-2609
(727) 834-8199
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4959
FL
Other
Enumeration date
06/03/2007
Last updated
04/29/2010
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