Provider Demographics
NPI:1710600663
Name:LI CAUSI, MICHELE ROSELLE (RD, ARNP, FNP-C, CDE)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ROSELLE
Last Name:LI CAUSI
Suffix:
Gender:F
Credentials:RD, ARNP, FNP-C, CDE
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:ROSELLE
Other - Last Name:SILANO LOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-495-4490
Mailing Address - Fax:239-495-4491
Practice Address - Street 1:26800 S TAMIAMI TRL STE 340
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4355
Practice Address - Country:US
Practice Address - Phone:239-495-4490
Practice Address - Fax:239-495-4491
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5698133V00000X
FLRN9529931163WD0400X
FLAPRN11022008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator