Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stacey C Azzolino, PA

Individual provider Physician Assistant · NPI 1770796625

Mrs. Stacey C Azzolino, PA is a Physician Assistant in Brooksville, Florida. Qualified in 2004, 22 years ago. Practices with West Florida Cardiology Network, LLC, a 84-clinician group and accepts Medicare assignment. Licensed in Florida, New Jersey and New York.

Years since qualifying
22
Licensed in
FL, NJ, NY
In the registry since
2007
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

12190 Cortez Blvd
Brooksville, FL 34613-5578
Phone: (352) 597-1206
Fax: (352) 597-1208
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9115496 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 009719-1 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 25MP00122900 (NJ)
Nurse Practitioner Taxonomy 363L00000X · Licence PA9115496 (FL)

Record details

NPI number1770796625
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 8, 2007
Last updated in NPPESFebruary 23, 2023
Certification dateFebruary 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice West Florida Cardiology Network, Llc — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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