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General NPI Number Information
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NPI Number | 1740587294
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Entity Type | Organization
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Legal Business Name | DIVERSE HEALTHCARE INITIATIVES FOR ECOLOGY, EPIDEMIOLOGY & EDUCATION
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 2002 DEL PRADO BLVD S STE 100
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City | CAPE CORAL
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State | FL
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Zip | 33990-4557
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Country | US
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Telephone | 239-248-9257
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Fax | 239-455-9259
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Provider Business Mailing Address
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Address Line | PO BOX 990405
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City | NAPLES
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State | FL
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Zip | 34116-6064
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Country | US
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Telephone | 239-248-9257
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Fax | 239-455-9259
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. CATHERINE CHIARADONNA
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Credential | ARNP
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Telephone | 239-248-9257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ARNP9191709
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License Number State | FL
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