1386901205 NPI number — MRS. STACEY ANN KASHI OTR/L, C/NDT

Table of content: MRS. STACEY ANN KASHI OTR/L, C/NDT (NPI 1386901205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386901205 NPI number — MRS. STACEY ANN KASHI OTR/L, C/NDT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASHI
Provider First Name:
STACEY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, C/NDT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COHEN
Provider Other First Name:
STACEY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L, C/NDT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386901205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10721 NW 5TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANTATION
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33324-1518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-474-1418
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10721 NW 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33324-1518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-474-1418
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2012

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: 225XP0200X , with the licence number:  OT2907 , 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)

  • Identifier: 00544600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005444600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com