MR. ANTWAN EDWARD LACY (NPI# 1477059376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477059376 |
| Entity Type | Individual |
| Full Name | MR. ANTWAN EDWARD LACY |
| Credential | FNP-C |
| Practice Address |
135 Commonwealth Ct N Saint Petersburg FL 33716-1301 |
| Practice Telephone | 7277989146 |
| Mailing Telephone | 7277989146 |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2018-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9372952 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
135 COMMONWEALTH CT N |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33716-1301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699205815 | Orthopaedic Medical Group of Tampa Bay Pa | Clinic/Center | 10033 Mlk Jr St N Fl 3, St Petersburg, FL 33716 | 2017-06-20 |
| 1316471113 | Sara Alexandra Maltese | Dentist | 871 Ibis Walk Pl N Unit 7201, St Petersburg, FL 33716 | 2017-04-18 |
| 1508229972 | Florida Cardiac Therapeutics, Inc | Internal Medicine | 10033 Doctor M.l.k. Jr St N, Suite 302, St Petersburg, FL 33716 | 2016-04-01 |
| 1720440902 | Valorie Baker | Day Training, Developmentally Disabled Services | 115 112th Ave Ne Apt 627, St Petersburg, FL 33716 | 2016-03-25 |
| 1346611142 | Theresa Bowen | Occupational Therapist | 810 S. Village Drive N, #103, St. Petersburg, FL 33716 | 2015-10-19 |
| 1356775423 | Paula J Smith | Massage Therapist | 400 Carillon Pkwy #130, Mountain Tree Massage, LLC, St. Petersburg, FL 33716 | 2013-08-26 |
| 1699118596 | Kellie L Kintz | Social Worker | 540 Carillon Parkway, Apartment 3026, The Promenade At Carillon, St. Petersburg, FL 33716 | 2013-04-10 |
| 1427398288 | St. Petersburg General Hospital | General Acute Care Hospital | 11850 Doctor Martin Luther King Jr. St. North, Apt 22-312, St Petersburg, FL 33716 | 2013-02-15 |
| 1952657314 | Trudy Anna Glover | Occupational Therapy Assistant | 11850 9th Street North, Apt 20208, St Petersburg, FL 33716 | 2012-08-02 |
| 1275834129 | Prison Rehabilitative Industries & Diversified Enterprises | Dental Laboratory | 12425 28th St. N., Suite 300, St. Petersburg, FL 33716 | 2010-11-09 |
| Find all providers in zip 33716 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689821 | Steven Michael Barker | Nurse Practitioner | 11800 Dr Martin Luther King Jr St N Apt 6303, Saint Petersburg, FL 33716-1656 | 2020-11-04 |
| 1801401815 | Rachel Leah Shapiro | Nurse Practitioner | 6798 Crosswinds Dr N Ste E101, Saint Petersburg, FL 33710-5479 | 2020-09-15 |
| 1023626637 | Tameckia Reece | Nurse Practitioner | 7509 39th Pl N, Saint Petersburg, FL 33709-4314 | 2020-07-20 |
| 1780202838 | Jillian Meaghan Lodico | Nurse Practitioner | 2721 60th Ave N, Saint Petersburg, FL 33714-1455 | 2020-07-06 |
| 1609497064 | Gloria A Oxendale | Nurse Practitioner | 201 4th St S Unit 520, Saint Petersburg, FL 33701-4565 | 2020-04-27 |
| 1396394227 | Tiffany Lynn D'angelo | Nurse Practitioner | 6870 11th Ave N, Saint Petersburg, FL 33710-6110 | 2019-09-04 |
| 1891347118 | Shakisha Lawson | Nurse Practitioner | Bay Pines Va Hospital, 10000 Bay Pines Blvd, Saint Petersburg, FL 33744 | 2019-07-16 |
| 1538623459 | Stephanie Grace Hunt | Nurse Practitioner | 6450 38th Ave N Ste 120, Saint Petersburg, FL 33710-1649 | 2019-01-24 |
| 1295299436 | Danielle Alexandra Duvoisin | Nurse Practitioner | 200 4th Ave S Unit 214, Saint Petersburg, FL 33701-4390 | 2019-01-22 |
| 1013491711 | Barbara Roserie | Nurse Practitioner | 3024 Bennett St N, Saint Petersburg, FL 33713-2638 | 2018-09-18 |
| Find all providers in SAINT PETERSBURG | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33716 |
Please comment or provide details below to improve the information on MR. ANTWAN EDWARD LACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.