Individual
STACIE BUCHANAN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10111 FOREST HILL BLVD #100, 100, WELLINGTON, FL 33414
(561) 798-1649
Mailing address
10111 FOREST HILL BLVD #, #100, WELLINGTON, FL 33414
(561) 798-1649
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9102048
FL
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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