Individual
TAMEKA STACEY-ANN FUNNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
39903
SC
207RI0200X
Infectious Disease Physician
OS11222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004076000
—
FL
01
—
14FV3
BCBSFL
FL
05
—
399037
—
SC
Enumeration date
08/09/2007
Last updated
03/16/2018
Update your record
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