Individual
STACY DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2103
(904) 953-7233
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2103
(904) 953-7233
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1752052
FL
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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