Healthcare Provider Details

I. General information

NPI: 1417481698
Provider Name (Legal Business Name): MRS. MAUREEN HOLDREITH DIGULIMIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13755 OLEANDER AVE
JUNO BEACH FL
33408-1623
US

IV. Provider business mailing address

13755 OLEANDER AVE
JUNO BEACH FL
33408-1623
US

V. Phone/Fax

Practice location:
  • Phone: 561-339-7848
  • Fax:
Mailing address:
  • Phone: 561-339-7848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License NumberMA28162
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: