Individual
STEPHANIE MARIE MASSA
Active
Individual
STEPHANIE MARIE MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00882
STATE LICENSE
RI
01
—
PA5780
PA STATE LICENSE
MA
01
—
PA9107140
PHYSICIAN ASSISTANT LICENSE
FL
Enumeration date
04/14/2013
Last updated
10/19/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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