Provider Demographics
NPI:1376785675
Name:DICARO, HELENE (PA)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:DICARO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:12866 HAMPTON LAKES CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8203
Mailing Address - Country:US
Mailing Address - Phone:561-504-2195
Mailing Address - Fax:
Practice Address - Street 1:13005 SOUTHERN BOULEVARD 221
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470
Practice Address - Country:US
Practice Address - Phone:561-798-8184
Practice Address - Fax:561-793-2588
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101767363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBS577ZMedicare UPIN