Individual
MRS. LACEY ELISSA ROSE-CRACCHIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-7494
(941) 917-7739
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9120077
FL
363AS0400X
Surgical Physician Assistant
—
NY
Other
Enumeration date
01/17/2024
Last updated
08/14/2025
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