MEDICARE: MRS. MEGHAN M DIMASI BSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	RN9498283	FL

General Provider Information

NPI Number	:	1710812649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGHAN M DIMASI BSN, RN

Provider Business Mailing Address
First Line	:	10869 BLACKTAIL LOOP
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-4568
Country	:	US
Telephone Number	:	870-838-3654
Fax Number	:

Provider Business Practice Location Address
First Line	:	10869 BLACKTAIL LOOP
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-4568
Country	:	US
Telephone Number	:	870-838-3654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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