Diane M. Digeronimo, LCSW, PA

Organization Active NPI Clinical Social Worker · Melbourne Beach, FL

NPI 1699077891 · NPPES record last updated Nov 18, 2024

Key facts

NPI
1699077891
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW2181 (FL)
Legal business name
DIANE M. DIGERONIMO, LCSW, PA
Practice address
321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569
Phone
(321) 230-3023
NPI assigned
Nov 22, 2010
Organization subpart
No

Authorized official

Name
Diane M Digeronimo, LCSW
Title
Provider
Phone
(321) 230-3023

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110517000635 FL Part B Supplier - Clinic/Group Practice 0042496598 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne Beach, FL

National Provider Directory

Locations

321 Ocean Ave
Ste 107
Melbourne Beach, FL 32951
Phone (321) 230-3023

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X SW2181 FL Yes

Addresses

Primary practice location

321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569

Mailing address

321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569
Phone (321) 230-3023

Other providers in Melbourne Beach, FL

All providers in Melbourne Beach, FL · Clinical Social Worker in Florida

Sources for this page

Verify at the official NPI Registry.