Provider Demographics
NPI:1629865472
Name:BUCHANAN, STACY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 VIA ABRUZZI
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6940
Mailing Address - Country:US
Mailing Address - Phone:561-975-5975
Mailing Address - Fax:
Practice Address - Street 1:12295 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2713
Practice Address - Country:US
Practice Address - Phone:305-893-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist