Organization
STACIA POOLE MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACIA POOLE MD (OWNER)
(321) 917-8472
Entity
Organization
Contact information
Practice address
930 S HARBOR CITY BLVD, SUITE 101, MELBOURNE, FL 32901-1963
(321) 917-8472
Mailing address
930 S HARBOR CITY BLVD, SUITE 101, MELBOURNE, FL 32901-1963
(321) 917-8472
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME51873
FL
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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