Individual
STACEY ANN SOUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3425 UNIVERSITY PKWY UNIT 102, SARASOTA, FL 34243-4271
(941) 746-7507
(941) 351-2668
Mailing address
367 S. GULPH ROAD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(941) 746-7507
(941) 351-3668
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
ME101589
FL
208D00000X
General Practice Physician
236615
NY
Other
Enumeration date
04/25/2007
Last updated
09/20/2021
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