Provider Demographics
NPI:1871590521
Name:STONE-GALE, VICKY ANN (ARNP, MSN)
Entity type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:ANN
Last Name:STONE-GALE
Suffix:
Gender:F
Credentials:ARNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7390 NW 5TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1610
Mailing Address - Country:US
Mailing Address - Phone:954-424-9300
Mailing Address - Fax:954-424-3315
Practice Address - Street 1:7390 NW 5TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1610
Practice Address - Country:US
Practice Address - Phone:954-424-9300
Practice Address - Fax:954-424-3315
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1929762363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S72594Medicare UPIN
FLY5146XMedicare ID - Type Unspecified