Individual
DR. STACI FLEISCHER KNICKREHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
L0343
TX
2084P0800X
Psychiatry Physician
Primary
OS9757
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042979703
—
TX
Enumeration date
06/01/2006
Last updated
07/09/2007
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