Individual
STACEY RESTUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 239-5814
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 239-5814
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5190683
FL
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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