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General NPI Number Information
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NPI Number | 1972618791
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Entity Type | Individual
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Provider Name | DIANE J MASSUCCI DNP, ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 801 MEADOWS RD STE 117
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City | BOCA RATON
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State | FL
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Zip | 33486-2346
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Country | US
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Telephone | 561-955-4565
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Fax | 561-955-5754
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Provider Business Mailing Address
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Address Line | 7966 RIVER ROCK RD
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2189
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Country | US
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Telephone | 516-528-7736
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Fax | 561-955-5754
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 360346
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | F302317 / 360346
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F302317
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9311818
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License Number State | FL
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