Provider Demographics
NPI:1710987599
Name:PRICE-MCCARTHY, STACI L (DC)
Entity Type:Individual
Prefix:DR
First Name:STACI
Middle Name:L
Last Name:PRICE-MCCARTHY
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 1:1539 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2393
Mailing Address - Country:US
Mailing Address - Phone:727-585-8644
Mailing Address - Fax:727-449-1981
Practice Address - Street 1:1539 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2393
Practice Address - Country:US
Practice Address - Phone:727-585-8644
Practice Address - Fax:727-449-1981
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381195600Medicaid
FLE2799AMedicare ID - Type Unspecified
FLU76012Medicare UPIN