Stacey Nichole Prunoske, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT12660 Issued in FL

Practice address

5901 Broken Sound Pkwy NW
Suite 500
Boca Raton, FL 33487-2773

Phone

(800) 875-8999

NPI assigned

Jun 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Club Staffing

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1568652972
  NPD (past)
• Club Staffing

  • Long Term Care Hospital
  • Fredericksburg, VA
  • NPI 1952509788
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609079946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SUMMIT ST",
            "address_2": "PO BOX 654",
            "city": "SHERBURNE",
            "state": "NY",
            "postal_code": "13460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROKEN SOUND PKWY NW",
            "address_2": "SUITE 500",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872773",
            "telephone_number": "800-875-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNOSKE",
        "first_name": "STACEY",
        "middle_name": "NICHOLE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6170",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12660",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provider Services of America, LLC
• Providers Who Care Home Health Agency LLC
• Provita Speech Language and Audiology Associates Corp
• James E Provo, MD
• Robert C. Prudente, RPH
• David W Prusakowski, DMD
• Rhonda F Pryluck, OTR/L
• Jessica Chollman Pryor, PHARMD
• PS Love Yourself LLC
• PSG of Naples LLC

• Occupational Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.