MEDICARE: DR. STACI APPLETON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME67829	FL
2	207R00000X	Internal Medicine Physician	ME0067829	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27109	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427162189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACI APPLETON MD

Provider Business Mailing Address
First Line	:	PO BOX 278
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32170
Country	:	US
Telephone Number	:	386-957-3999
Fax Number	:	386-402-7920

Provider Business Practice Location Address
First Line	:	405 DOWNING ST
Second Line	:	C/O APPLETON INTERNAL MEDICINE
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7109
Country	:	US
Telephone Number	:	386-957-3999
Fax Number	:	386-402-7920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/12/2024

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