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NPI Code Detail

MEDICARE: MRS. STEPHANIE ALTAGRACIA METAYER PA

MEDICARE: MRS. STEPHANIE ALTAGRACIA METAYER PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1073049615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE ALTAGRACIA METAYER PA
Provider Business Mailing Address
First Line : 950 NW 20TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33127-4622
Country : US
Telephone Number : 305-237-4141
Fax Number :
Provider Business Practice Location Address
First Line : 950 NW 20TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33127-4622
Country : US
Telephone Number : 305-237-4141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 05/04/2017

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Directions to “ MRS. STEPHANIE ALTAGRACIA METAYER PA” Practice Location

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