Healthcare Provider Details

I. General information

NPI: 1649660424
Provider Name (Legal Business Name): CAM TU FRANCESCONE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10080 SW INNOVATION WAY
PORT ST LUCIE FL
34987-2127
US

IV. Provider business mailing address

10080 SW INNOVATION WAY
PORT ST LUCIE FL
34987-2127
US

V. Phone/Fax

Practice location:
  • Phone: 772-344-3811
  • Fax:
Mailing address:
  • Phone: 772-344-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.PA.70019730
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA5272
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: