Provider Demographics
NPI:1033179015
Name:MURRAY, STACEY R (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:R
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 144655
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4655
Mailing Address - Country:US
Mailing Address - Phone:305-793-8296
Mailing Address - Fax:305-598-8680
Practice Address - Street 1:7800 SW 87TH AVE
Practice Address - Street 2:SUITE C320
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-598-8787
Practice Address - Fax:305-598-8680
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0065824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF94587Medicare UPIN
FL26372BMedicare ID - Type Unspecified