Healthcare Provider Details

I. General information

NPI: 1740378322
Provider Name (Legal Business Name): JANE ANN DACRI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N 12TH AVE BLDG B
ARCADIA FL
34266-8752
US

IV. Provider business mailing address

PO BOX 93-4068
MARGATE FL
33093
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-5250
  • Fax: 239-936-9970
Mailing address:
  • Phone: 954-366-2700
  • Fax: 954-366-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberARNP9182239
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9182239
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN9182239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: