Provider Demographics
NPI:1740587294
Name:DIVERSE HEALTHCARE INITIATIVES FOR ECOLOGY, EPIDEMIOLOGY & EDUCATION
Entity type:Organization
Organization Name:DIVERSE HEALTHCARE INITIATIVES FOR ECOLOGY, EPIDEMIOLOGY & EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:239-248-9257
Mailing Address - Street 1:PO BOX 990405
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6064
Mailing Address - Country:US
Mailing Address - Phone:239-248-9257
Mailing Address - Fax:239-455-9259
Practice Address - Street 1:2002 DEL PRADO BLVD S STE 100
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-4557
Practice Address - Country:US
Practice Address - Phone:239-248-9257
Practice Address - Fax:239-455-9259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIVERSE HEALTHCARE INITIATIVES FOR ECOLOGY, EPIDEMIOLOGY & EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9191709261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care