STACEY LEE GLEIM (NPI# 1891102455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891102455 |
| Entity Type | Individual |
| Full Name | STACEY LEE GLEIM |
| Credential | PA-C |
| Practice Address |
3450 Hull Road Gainesville FL 32611-2727 |
| Practice Telephone | 3522737374 |
| Mailing Telephone | 3522737374 |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2018-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9107985 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 012976400 | 05 |
| Street Address |
3450 HULL ROAD |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32611-2727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902862428 | Aimee Michelle Struk | Specialist | 3450 Hull Road, Uf Orthopaedics & Sports Medicine Inst/div of Research, Gainesville, FL 32607 | 2006-04-24 |
| 1184285546 | Ka Loong Kelvin Au | Student in an Organized Health Care Education/Training Program | 3450 Hull Road, Gainesville, FL 32607 | 2019-06-26 |
| 1518020684 | Carolyn Geis | Physical Medicine & Rehabilitation | 3450 Hull Road, Gainesville, FL 32611-2765 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235607813 | Sayuri Kitada | Student in an Organized Health Care Education/Training Program | 1908 Stadium Road, Gainesville, FL 32611 | 2018-11-13 |
| 1780938621 | Analesa Clarke | Psychologist | 3190 Radio Rd, Gainesville, FL 32611 | 2012-10-30 |
| 1659496107 | J. Chris Patrick | Specialist/Technologist | Bhg Stadium, Gale Lemerand Dr., Gainesville, FL 32611 | 2007-03-20 |
| 1780711424 | Susan A Donaldson | Nurse Practitioner | 101 S Newell Avenue, Gainesville, FL 32611 | 2007-02-28 |
| 1225117039 | Lance S. Governale | Neurological Surgery | 1149 South Newell Drive;, Univ of Florida; Dept of Neurosurgery; Room L2-100, Gainesville, FL 32611 | 2006-11-03 |
| 1851493191 | Larry Markel Lopez | Pharmacist | 101 South Newell Dr., Hpnp Bldg 212; Room 3309, Gainesville, FL 32611 | 2006-09-05 |
| 1194708065 | Pamela Pieper | Nurse Practitioner | 101 S Newell Drive, Gainesville, FL 32611 | 2005-11-23 |
| 1003436130 | Gerald Richardson IIi | Student in an Organized Health Care Education/Training Program | 100 Newell Dr, Gainesville, FL 32611 | 2020-04-18 |
| 1033774120 | George Joseph Raineri | Student in an Organized Health Care Education/Training Program | 100 S Newell Dr, L4100, Mcknight Brain Institute, Gainesville, FL 32611 | 2019-05-05 |
| 1962907691 | Regan Kemp | Specialist/Technologist | 3150 Hull Rd, Gainesville, FL 32611 | 2018-03-26 |
| Find all providers in zip 32611 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659806248 | Bluff Drive Medical | Physician Assistant | 954 Memorial Dr, Gainesville, GA 30501-2334 | 2017-04-21 |
| 1891085692 | Brevard Surgical Solutions L.L.C. | Physician Assistant | 11302 Nw 31st Rd, Gainesville, FL 32606-6840 | 2011-04-13 |
| 1700180627 | Julie Marie Haberski | Physician Assistant | 5630 Chestatee Landing Dr, Gainesville, GA 30506-6815 | 2011-01-06 |
| 1902853286 | Jean Dietrich Megenity | Physician Assistant | 10026 Nw 12th Ln, Gainesville, FL 32606-8017 | 2006-05-30 |
| 1366417149 | James William Becker | Physician Assistant | 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 | 2006-02-23 |
| 1578547832 | Dawn M Ferrer | Physician Assistant | 1296 Sims St Ste B, Gainesville, GA 30501-3873 | 2005-12-01 |
| 1962000950 | Kelli O'shaughnessy | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-13 |
| 1346847944 | Nicholas Scott Duarte | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-06 |
| 1023643251 | Robert J Poole | Physician Assistant | 743 Spring St Ne, Gainesville, GA 30501-3899 | 2020-03-09 |
| 1912541533 | Samantha Morgan Kleiber | Physician Assistant | 1240 Jesse Jewell Pkwy Se Ste 300, Gainesville, GA 30501-3861 | 2019-11-06 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32611 |
Please comment or provide details below to improve the information on STACEY LEE GLEIM.
| 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.