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General NPI Number Information
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NPI Number | 1710415195
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Entity Type | Organization
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Legal Business Name | DIVINITY GROUP, INC.
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1223 ENTERPRISE DR UNIT A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33953-3847
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Country | US
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Telephone | 941-249-1609
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Fax | 941-613-9524
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Provider Business Mailing Address
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Address Line | 1223 ENTERPRISE DR UNIT A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33953-3847
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Country | US
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Telephone | 941-249-1609
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Fax | 941-613-9524
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ANTHONY VIGLIOTTI
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Credential |
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Telephone | 941-249-1609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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