MEDICARE: MICHELE ROSELLE LI CAUSI RD, ARNP, FNP-C, CDE

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	133V00000X	Registered Dietitian	ND5698	FL
2	363LF0000X	Family Nurse Practitioner	324009	AZ
3	163WD0400X	Diabetes Educator Registered Nurse	RN9529931	FL
4	363LF0000X	Family Nurse Practitioner	APRN11022008	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710600663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE ROSELLE LI CAUSI RD, ARNP, FNP-C, CDE

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-495-4490
Fax Number	:	239-495-4491

Provider Business Practice Location Address
First Line	:	2720 S 6TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-4701
Country	:	US
Telephone Number	:	520-475-5418
Fax Number	:	520-300-8034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	10/03/2025

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