MEDICARE: DR. STACEY ANN STEFANSKI DC

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	111N00000X	Chiropractor	38MC00582700	NJ
2	111N00000X	Chiropractor	8303	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1598215717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACEY ANN STEFANSKI DC

Provider Business Mailing Address
First Line	:	9109 SOUTH US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952
Country	:	US
Telephone Number	:	845-380-7610
Fax Number	:	772-281-4817

Provider Business Practice Location Address
First Line	:	9109 SOUTH US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952
Country	:	US
Telephone Number	:	772-337-1300
Fax Number	:	800-783-5176

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

Provider Enumeration Date	:	10/12/2016
Last Update Date	:	10/13/2021

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Directions to “ DR. STACEY ANN STEFANSKI DC” Practice Location

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