MEDICARE: MS. LAUREL E CICCARELLO ARNP

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	363LF0000X	Family Nurse Practitioner	1426672	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	:	1790722957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREL E CICCARELLO ARNP

Provider Business Mailing Address
First Line	:	7619 ULIVA WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-4797
Country	:	US
Telephone Number	:	813-924-4787
Fax Number	:

Provider Business Practice Location Address
First Line	:	237 PAYNE PKWY UNIT 101
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34237-7018
Country	:	US
Telephone Number	:	941-893-2556
Fax Number	:

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	12/09/2025

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