MRS. LUCILLE MALVINA FANTAUZZI (NPI# 1609401967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609401967 |
| Entity Type | Individual |
| Full Name | MRS. LUCILLE MALVINA FANTAUZZI |
| Credential | APRN, FNP-C |
| Practice Address |
205 20th Ave Vero Beach FL 32962-2704 |
| Practice Telephone | 7726461374 |
| Mailing Telephone | 7726461374 |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 9342743 | FL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11006482 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
205 20TH AVE |
| City | VERO BEACH |
| State | FL |
| Zip Code | 32962-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811512577 | Brennen T Murphy | Behavior Technician | 2036 15th St Sw, Vero Beach, FL 32962 | 2020-06-09 |
| 1912426289 | Dacia Rose Swartz | Technician, Other | 241 14th. St. Sw, Vero Beach, FL 32962 | 2017-09-18 |
| 1336688670 | Diamond Behavioral Services | Behavior Technician | 460 7th Place, Vero Beach, FL 32962 | 2017-02-20 |
| 1093148736 | Ashley Ann Baum | Nurse Practitioner | 1545 9th St. S.w., Vero Beach, FL 32962 | 2013-08-16 |
| 1215379631 | Charlene Marylee Foulk | Nurse's Aide | 985 23rd Place Sw, Vero Beach, FL 32962 | 2013-07-26 |
| 1295028314 | John Robert Moore | Behavioral Analyst | 815 24th St Sw, Vero Beach, FL 32962 | 2011-05-23 |
| 1801042825 | Celena Benjamin | Counselor | 950 6th Ln, Vero Beach, FL 32962 | 2008-08-10 |
| 1881882736 | Mary K Mackanos | Massage Therapist | 396 10th Ct, Vero Beach, FL 32962 | 2007-10-04 |
| 1659494813 | Shirley Ann Allen | Home Health Aide | 2155 15 St Sw, Oslo Park, Vero Beach, FL 32962 | 2007-04-10 |
| 1740347343 | Charles Kerth Stewart | Veterinarian | 890 Old Dixie Highway Sw, Live Oak Animal Hospital, Vero Beach, FL 32962 | 2007-01-02 |
| Find all providers in zip 32962 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477166627 | Nicole Guettler | Nurse Practitioner | 722 Broadway St, Vero Beach, FL 32960-5118 | 2020-08-27 |
| 1124659594 | Kimberly G Anderson | Nurse Practitioner | 4089 42nd Sq, Vero Beach, FL 32967-1963 | 2020-02-03 |
| 1760042972 | Megan Dean | Nurse Practitioner | 305 8th Ter, Vero Beach, FL 32962-2813 | 2019-06-19 |
| 1972001865 | Allison E Mills | Nurse Practitioner | 2546 Fairway Dr, Vero Beach, FL 32960-5005 | 2018-01-25 |
| 1124493432 | Macresia Ann Braziel | Nurse Practitioner | 3450 11th Ct Ste 305a, Vero Beach, FL 32960-5012 | 2015-12-11 |
| 1306214671 | Krista Mazzarella | Nurse Practitioner | 4141 Abington Woods Cir, Vero Beach, FL 32967-8812 | 2015-09-03 |
| 1952787392 | Sharon Webb Mezzina | Nurse Practitioner | 525 38th Ave, Vero Beach, FL 32968-1928 | 2015-08-08 |
| 1245632140 | Elizabeth Sofranko Adams | Nurse Practitioner | 7275 49th St, Vero Beach, FL 32967-5824 | 2014-09-23 |
| 1013325448 | George Estol Wadsworth | Nurse Practitioner | 275 18th St Ste 102, Vero Beach, FL 32960-0824 | 2014-07-29 |
| 1356756894 | Gerri Kroop | Nurse Practitioner | 1243 Tan Oak Pl, Vero Beach, FL 32966-4737 | 2014-06-24 |
| Find all providers in VERO BEACH | ||||
| City | VERO BEACH |
| Zip Code | 32962 |
Please comment or provide details below to improve the information on MRS. LUCILLE MALVINA FANTAUZZI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.