Individual
STACIE LAURO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3923 W LEONA ST, TAMPA, FL 33629-7825
(813) 944-8226
Mailing address
3923 W LEONA ST, TAMPA, FL 33629-7825
(813) 944-8226
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
213592
NY
2084P0800X
Psychiatry Physician
Primary
ME108388
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003358900
—
FL
05
—
02409429
—
NY
01
—
117788EU
PREFERRED CARE
—
01
—
P010213592
EXCELLUS
—
Enumeration date
02/16/2007
Last updated
12/19/2018
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