Provider Demographics
NPI:1417481698
Name:DIGULIMIO, MAUREEN HOLDREITH
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:HOLDREITH
Last Name:DIGULIMIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13755 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1623
Mailing Address - Country:US
Mailing Address - Phone:561-339-7848
Mailing Address - Fax:
Practice Address - Street 1:13755 OLEANDER AVE
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1623
Practice Address - Country:US
Practice Address - Phone:561-339-7848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA28162405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional