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General NPI Number Information
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NPI Number | 1467291609
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Entity Type | Individual
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Provider Name | NICOLETTE FRANCESCA DIGREGORIO PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1430 SW SAINT LUCIE WEST BLVD STE 101
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-2134
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Country | US
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Telephone | 561-250-6169
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 VINE CLIFF WAY E
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6793
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Country | US
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Telephone | 561-568-2342
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9119709
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License Number State | FL
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