Healthcare Provider Details

I. General information

NPI: 1528995115
Provider Name (Legal Business Name): GIACCHINO MEDICAL & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 NW 34TH AVE
CAPE CORAL FL
33993-9519
US

IV. Provider business mailing address

1523 NW 34TH AVE
CAPE CORAL FL
33993-9519
US

V. Phone/Fax

Practice location:
  • Phone: 239-224-9919
  • Fax: 765-435-3499
Mailing address:
  • Phone: 239-224-9919
  • Fax: 765-435-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GIOVANNA K GIACCHINO
Title or Position: NURSE PRACTITIONER
Credential: FNP-BC
Phone: 239-224-9919