Healthcare Provider Details

I. General information

NPI: 1710236435
Provider Name (Legal Business Name): DAWN CHIARENZA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SE HILLMOOR DR
PORT SAINT LUCIE FL
34952-7539
US

IV. Provider business mailing address

1700 SE HILLMOOR DR
PORT SAINT LUCIE FL
34952-7539
US

V. Phone/Fax

Practice location:
  • Phone: 772-335-9600
  • Fax: 772-335-9699
Mailing address:
  • Phone: 772-335-9600
  • Fax: 772-335-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3182642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: