Provider Demographics
NPI:1013695055
Name:FELIX, STACY RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:RENEE
Last Name:FELIX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 COUNTRYSIDE BLVD UNIT 12
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1306
Mailing Address - Country:US
Mailing Address - Phone:859-325-3059
Mailing Address - Fax:
Practice Address - Street 1:12629 HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8588
Practice Address - Country:US
Practice Address - Phone:859-325-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027318363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health