Provider Demographics
NPI:1699172205
Name:STECKO, NATALIE ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNE
Last Name:STECKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:KACZMAR-STECKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2363 NW 162ND TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1703
Mailing Address - Country:US
Mailing Address - Phone:248-622-3813
Mailing Address - Fax:305-653-5513
Practice Address - Street 1:2801 NW 87TH AVE UNIT 7
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1603
Practice Address - Country:US
Practice Address - Phone:305-653-5155
Practice Address - Fax:305-653-5513
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMPA2241363AM0700X
FL9109126363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical