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NPI Code Detail

MEDICARE: KAMI STUCKEY CRNA

MEDICARE: KAMI STUCKEY CRNA
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
1163W00000XRegistered NurseRN9403034FL
2367500000XCertified Registered Nurse Anesthetist132139FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558966036
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMI STUCKEY CRNA
Provider Business Mailing Address
First Line : 2520 NW 84TH AVE APT 301
Second Line :
City : DORAL
State : FL
Zip : 33122-1541
Country : US
Telephone Number : 786-857-7124
Fax Number :
Provider Business Practice Location Address
First Line : 2801 NW 79TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33122-1174
Country : US
Telephone Number : 786-466-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 01/19/2022

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Directions to “ KAMI STUCKEY CRNA” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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