Individual
STACEY LEE GLEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3450 HULL ROAD, GAINESVILLE, FL 32611-2727
(352) 273-7374
Mailing address
3450 HULL ROAD, GAINESVILLE, FL 32611-2727
(352) 273-7374
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9107985
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012976400
—
FL
Enumeration date
07/16/2014
Last updated
04/02/2018
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