Provider Demographics
NPI:1922045806
Name:PUGLIESE, DALE B (RN)
Entity Type:Individual
Prefix:MRS
First Name:DALE
Middle Name:B
Last Name:PUGLIESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DALE
Other - Middle Name:B
Other - Last Name:PUGLIESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:340 WOOD DALE DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4754
Mailing Address - Country:US
Mailing Address - Phone:561-784-7115
Mailing Address - Fax:
Practice Address - Street 1:38754 STATE ROAD 80
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-5615
Practice Address - Country:US
Practice Address - Phone:561-996-1600
Practice Address - Fax:561-992-8363
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9168533163WC1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9168533OtherRN