Individual
ELIZABETH STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3181
(352) 273-6815
(352) 627-4172
Mailing address
PO BOX 100247, GAINESVILLE, FL 32610-0247
(352) 273-6870
(352) 273-7515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01538
WV
363A00000X
Physician Assistant
Primary
PA9110057
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021286900
—
FL
Enumeration date
03/31/2011
Last updated
11/01/2023
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