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NPI Code Detail

MEDICARE: STACEY M CADAVAL NP

MEDICARE: STACEY M CADAVAL NP
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
1363L00000XNurse PractitionerAPN 001073NV

General Provider Information

NPI Number : 1518118850
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY M CADAVAL NP
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4001 S DECATUR BLVD STE 25
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5857
Country : US
Telephone Number : 725-224-6967
Fax Number : 833-749-0357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2008
Last Update Date : 02/13/2026

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