Provider Demographics
NPI:1467701532
Name:DIGIORGIO, MARY ELIZABETH (AAPRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:DIGIORGIO
Suffix:
Gender:F
Credentials:AAPRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 W NEW HAVEN AVE # 303
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3661
Mailing Address - Country:US
Mailing Address - Phone:321-376-1375
Mailing Address - Fax:
Practice Address - Street 1:2903 W NEW HAVEN AVE # 303
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3661
Practice Address - Country:US
Practice Address - Phone:321-376-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3001392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner