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General NPI Number Information
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NPI Number | 1225363195
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Entity Type | Individual
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Provider Name | MS. STACIE DENISE ACKERMAN
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Gender | Female
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Dates
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Enumeration Date | 10/12/2009
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Last Update Date | 10/12/2009
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Provider Practice Location Address
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Address Line | 2350 W OAKLAND PARK BLVD SUITE 650
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1419
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Country | US
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Telephone | 954-731-8097
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Fax | 954-733-6892
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Provider Business Mailing Address
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Address Line | 2900 NW 125TH AVE APT. 320
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City | SUNRISE
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State | FL
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Zip | 33323-6329
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Country | US
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Telephone | 561-706-7437
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Fax | 561-740-9515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA23625
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License Number State | FL
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