Provider Demographics
NPI:1003529173
Name:STELZER, RAQUEL (APRN)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:STELZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ANTIGUA WAY
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1201
Mailing Address - Country:US
Mailing Address - Phone:321-501-1209
Mailing Address - Fax:
Practice Address - Street 1:1631 RACE TRACK RD
Practice Address - Street 2:#101
Practice Address - City:FRUIT COVE
Practice Address - State:FL
Practice Address - Zip Code:32259
Practice Address - Country:US
Practice Address - Phone:904-230-7977
Practice Address - Fax:904-230-7979
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017163363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics