Lucille Malvina Fantauzzi, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11006482 Issued in FL

Practice address

1265 36TH St
Vero Beach, FL 32960-6574

Phone

(772) 567-6340

Fax

(772) 567-3564

NPI assigned

Mar 6, 2020

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NHC Homecare Home health agency, Vero Beach, FL, CCN 107515
• Visiting Nurse Association of Indian River County Inc Home health agency, Vero Beach, FL, CCN 107134
• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Indian River Health Services Inc

  dba Behavioral Health Center

  • Psychiatry Physician
  • Vero Beach, FL
  • NPI 1710933031
  Medicare reassignment Care Compare group NPD
• Indian River Health Services Inc

  dba Irhs-Cardiology North

  • Cardiovascular Disease Physician
  • Sebastian, FL
  • NPI 1659651990
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indian River Memorial Hospital Inc

  dba Cleveland Clinic Indian River Hospital

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988
  Care Compare affiliation
• Martin Memorial Medical Center Inc

  dba Cleveland Clinic Martin North, South, Tradition Hospitals

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation
• NHC-Op LP

  • Home Health Agency
  • Vero Beach, FL
  • NPI 1629009972
  Care Compare affiliation
• Visiting Nurse Association of Indian River County, Inc.

  • Home Health Agency
  • Vero Beach, FL
  • NPI 1306843768
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1609401967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606574",
            "telephone_number": "772-567-6340",
            "fax_number": "772-567-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606574",
            "telephone_number": "772-567-6340",
            "fax_number": "772-567-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTAUZZI",
        "first_name": "LUCILLE",
        "middle_name": "MALVINA",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006482",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9342743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Elizabeth Fallon, OTR
• Family Extended Care of Vero Beach, Inc. (Century Oaks)
• Family Home Health Services LLC
• Family Plus Home Care
• Family Preservation Services of Florida
• Gloria Farina, M.D.
• Brianna Farnell, PA-C
• Vicki Lynn Farnham Perham, LCSW
• Muhammad Farooq, M.D.
• Tiffany Nicole Farrar, RN

• Family Nurse Practitioner in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.