Healthcare Provider Details

I. General information

NPI: 1982028304
Provider Name (Legal Business Name): PATRICIA DEL VECCHIO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA CARACCIO

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19531 COCHRAN BLVD
PORT CHARLOTTE FL
33948-2081
US

IV. Provider business mailing address

3434 HANCOCK BRIDGE PKWY STE 301
NORTH FORT MYERS FL
33903-7094
US

V. Phone/Fax

Practice location:
  • Phone: 941-255-3535
  • Fax: 941-766-7999
Mailing address:
  • Phone: 877-856-3774
  • Fax: 239-599-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NO11786600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9396335
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00490800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: