Healthcare Provider Details

I. General information

NPI: 1710600663
Provider Name (Legal Business Name): MICHELE ROSELLE LI CAUSI RD, ARNP, FNP-C, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE ROSELLE SILANO LOTT APRN

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 S 6TH AVE
TUCSON AZ
85713-4701
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 520-475-5418
  • Fax: 520-300-8034
Mailing address:
  • Phone: 239-495-4490
  • Fax: 239-495-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND5698
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number324009
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN9529931
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022008
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: