Provider Demographics
NPI:1740203033
Name:WARD, STEPHANIE J (AP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:WARD
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3102
Mailing Address - Country:US
Mailing Address - Phone:305-282-5429
Mailing Address - Fax:
Practice Address - Street 1:301 CIVIC CT STE 102
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6001
Practice Address - Country:US
Practice Address - Phone:305-282-5429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1133171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist