Provider Demographics
NPI:1104896026
Name:STUDZINSKI, MARCY ANN (DO)
Entity type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:ANN
Last Name:STUDZINSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NEBRASKA AVENUE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4837
Mailing Address - Country:US
Mailing Address - Phone:772-465-4499
Mailing Address - Fax:772-466-0832
Practice Address - Street 1:1900 NEBRASKA AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4837
Practice Address - Country:US
Practice Address - Phone:772-465-4499
Practice Address - Fax:772-466-0832
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-6966207RC0000X
FLMEOS6966207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF42909Medicare UPIN
K1415Medicare PIN
57350Medicare ID - Type Unspecified
F42909Medicare UPIN