Provider Demographics
NPI:1225718869
Name:DONOFRIO, DIANA LYNN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:DONOFRIO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 CROSSWINDS DR N STE G
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5472
Mailing Address - Country:US
Mailing Address - Phone:727-803-6016
Mailing Address - Fax:
Practice Address - Street 1:6740 CROSSWINDS DR N STE G
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5472
Practice Address - Country:US
Practice Address - Phone:727-803-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299995707251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health