Healthcare Provider Details

I. General information

NPI: 1720796469
Provider Name (Legal Business Name): INFINITY HEALTHCARE FORT PIERCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 VIRGINIA AVE
FORT PIERCE FL
34982-3522
US

IV. Provider business mailing address

2730 N STATE ROAD 7
MARGATE FL
33063-5726
US

V. Phone/Fax

Practice location:
  • Phone: 772-666-1801
  • Fax: 754-222-6417
Mailing address:
  • Phone: 954-586-8058
  • Fax: 754-222-6417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH DICAPUA
Title or Position: CEO
Credential:
Phone: 561-843-7720