1932269891 NPI number — DR. VANESSA STAPLETON-WAUGH D.C.

Table of content: DR. VANESSA STAPLETON-WAUGH D.C. (NPI 1932269891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932269891 NPI number — DR. VANESSA STAPLETON-WAUGH D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAPLETON-WAUGH
Provider First Name:
VANESSA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WAUGH
Provider Other First Name:
VANESSA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1932269891
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
516 LAKEVIEW RD STE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33756-3302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-687-6454
Provider Business Mailing Address Fax Number:
727-466-1950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
516 LAKEVIEW ROAD
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33756-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-687-6454
Provider Business Practice Location Address Fax Number:
727-466-1950
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH9745 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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