Provider Demographics
NPI:1619296589
Name:STANLEY, KEELA RAMSEY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KEELA
Middle Name:RAMSEY
Last Name:STANLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 SUNTREE PL
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7689
Mailing Address - Country:US
Mailing Address - Phone:321-253-3944
Mailing Address - Fax:321-253-4990
Practice Address - Street 1:2 SUNTREE PL
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7689
Practice Address - Country:US
Practice Address - Phone:321-253-3944
Practice Address - Fax:321-253-4990
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD 410363A00000X
AZ5107363AM0700X
FLPA9113534363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant