Provider Demographics
NPI:1043300361
Name:RAGUSEA, STEPHEN ANTHONY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:RAGUSEA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 FOGARTY AVE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3614
Mailing Address - Country:US
Mailing Address - Phone:305-294-2500
Mailing Address - Fax:
Practice Address - Street 1:1901 FOGARTY AVE
Practice Address - Street 2:SUITE #5
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3614
Practice Address - Country:US
Practice Address - Phone:305-294-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6469103TC0700X
PAPS004089L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3909Medicare ID - Type Unspecified