Provider Demographics
NPI:1598215717
Name:STEFANSKI, STACEY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ANN
Last Name:STEFANSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 SOUTH US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952
Mailing Address - Country:US
Mailing Address - Phone:845-380-7610
Mailing Address - Fax:772-281-4817
Practice Address - Street 1:9109 SOUTH US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952
Practice Address - Country:US
Practice Address - Phone:772-337-1300
Practice Address - Fax:800-783-5176
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00582700111N00000X
FL8303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor