| Diane M. Digeronimo, Lcsw, Pa | |
|
2194 Highway A1a Suite 203 Indian Harbour Beach FL 32937-4930 | |
| (321) 777-8930 | |
| (321) 773-5479 |
| Full Name | Diane M. Digeronimo, Lcsw, Pa |
|---|---|
| Speciality | Social Worker |
| Location | 2194 Highway A1a, Indian Harbour Beach, Florida |
| Authorized Official Name and Position | Diane M Digeronimo (PRESIDENT) |
| Authorized Official Contact | 3217778930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane M. Digeronimo, Lcsw, Pa 2194 Highway A1a Suite 203 Indian Harbour Beach FL 32937-4930 Ph: (321) 777-8930 | Diane M. Digeronimo, Lcsw, Pa 2194 Highway A1a Suite 203 Indian Harbour Beach FL 32937-4930 Ph: (321) 777-8930 |
| NPI Number | 1699077891 |
|---|---|
| Provider Enumeration Date | 11/22/2010 |
| Last Update Date | 11/22/2010 |
| Medicare PECOS PAC ID | 0042496598 |
|---|---|
| Medicare Enrollment ID | O20110517000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699077891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW2181 (Florida) | Primary |
| Provider Name | Diane M Digeronimo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083652002 PECOS PAC ID: 0749466290 Enrollment ID: I20110517000681 |
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