Healthcare Provider Details

I. General information

NPI: 1134042294
Provider Name (Legal Business Name): MRS. ALLYSON DIFRANCESCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SE TIFFANY AVE
PORT ST LUCIE FL
34952-7521
US

IV. Provider business mailing address

3354 S BROCKSMITH RD
FORT PIERCE FL
34945-4426
US

V. Phone/Fax

Practice location:
  • Phone: 772-335-4000
  • Fax:
Mailing address:
  • Phone: 772-332-5207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11049762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: