Stables on Buck Lake LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STABLES ON BUCK LAKE LLC

Practice address

9400 Buck Lake Rd
Tallahassee, FL 32317-8470

Phone

(850) 629-6565

NPI assigned

Nov 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Spencer Brass

Title

Owner

Phone

(850) 629-6565

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1245055847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 BUCK LAKE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323178470",
            "telephone_number": "850-629-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 BUCK LAKE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323178470",
            "telephone_number": "850-629-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STABLES ON BUCK LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "BRASS",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-629-6565"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna J St Hillier, PHD
• Daphne St Juste
• Louis St Petery, M.D.
• Joanna St. John, RD
• Rylee Staats
• Selika Stackhouse Sampson, PHARMD
• Jacquelyn Marie Stacy, LMT
• Kaitlynn Stafford
• Sotiris Stamou, MD
• Stand Up MRI of Tallahassee Inc

• Community/Behavioral Health Agency in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.