MEDICARE: TOTAL P.I.C.C. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN2634552	FL
2	163WH0200X	Home Health Registered Nurse	RN2634552	FL
3	163WI0500X	Infusion Therapy Registered Nurse	RN2634552	FL

General Provider Information

NPI Number	:	1649375221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL P.I.C.C. PA

Provider Business Mailing Address
First Line	:	2436 NORTH FEDERAL HWY
Second Line	:	217
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-6853
Country	:	US
Telephone Number	:	800-496-6080
Fax Number	:	954-531-1504

Provider Business Practice Location Address
First Line	:	1309 SE 1ST TERRACE
Second Line	:
City	:	DEERFIELD BEACH
State	:	LA
Zip	:	33441-6701
Country	:	US
Telephone Number	:	800-496-6080
Fax Number	:	954-531-1504

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CYNTHIA GAY FORTNEY
Credential	:	RN
Telephone Number	:	800-496-6080

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/11/2025

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