MEDICARE: PETE M. DECUIR APRN (N.P)

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	363L00000X	Nurse Practitioner	002695	CT
2	363L00000X	Nurse Practitioner	173962	MA
3	363L00000X	Nurse Practitioner	ARNP9443567	FL

General Provider Information

NPI Number	:	1912927781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETE M. DECUIR APRN (N.P)

Provider Business Mailing Address
First Line	:	2392 SE OCEAN BLVD
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34996-3310
Country	:	US
Telephone Number	:	772-223-4978
Fax Number	:	772-223-2847

Provider Business Practice Location Address
First Line	:	2392 SE OCEAN BLVD
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34996-3310
Country	:	US
Telephone Number	:	772-223-4978
Fax Number	:	772-223-2847

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/21/2022

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