Stacy-Ann Melissa Emmanuel

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

22335 Issued in FL

Practice address

4850 W Oakland Park Blvd Ste 201
Lauderdale Lakes, FL 33313-7268

Phone

(954) 735-1035

NPI assigned

Jan 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1770855421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "954-735-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "954-735-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "STACY-ANN",
        "middle_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "22335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J Elder, LMFT
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• Dawn Elaine Ellicott Clinkscale, LMFT
• Raynesha Andrea Ellington, M.A., BCBA, LBA
• Mattia Epps, OTD, OTR/L
• Herman Myron Epstein, M.D. F.A.C.O.G
• Paula Belen Espinoza Berrezueta, MD
• Karina Ninet Espinoza Ferretti, RBT
• Ariadna Estrada

• Physical Therapy Assistant in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.