Provider Demographics
NPI:1205204195
Name:SCHAEFER, STACIA LORRAINE
Entity Type:Individual
Prefix:DR
First Name:STACIA
Middle Name:LORRAINE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STACIA
Other - Middle Name:LORRAINE
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1343 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8317
Mailing Address - Country:US
Mailing Address - Phone:734-255-8067
Mailing Address - Fax:
Practice Address - Street 1:439 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3538
Practice Address - Country:US
Practice Address - Phone:734-255-8067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist