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1154965341
STACY JEAN
HOLLYWOOD, FL
NPI
1154965341
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11004751)
Enumeration Date
2019-10-31
Last Update Date
2019-10-31
Business Address
STACY JEAN
6500 GRANT ST
HOLLYWOOD, FL 33024-5840
Phone number: 407-922-0733
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Mailing Address
STACY JEAN
6500 GRANT ST
HOLLYWOOD, FL 33024-5840
Phone number: 407-922-0733
Copy
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