Healthcare Provider Details

I. General information

NPI: 1629861356
Provider Name (Legal Business Name): FRANCES ROSE LACIVITA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FRANCES ROSE DENIRO

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 VENETIA BAY BLVD STE 110
VENICE FL
34285-8042
US

IV. Provider business mailing address

2675 WINKLER AVE STE 200
FORT MYERS FL
33901-9328
US

V. Phone/Fax

Practice location:
  • Phone: 941-484-4778
  • Fax:
Mailing address:
  • Phone: 877-856-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11042353
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: