Active NPI
Donna Antenucci, LPN, IBCLC
- Specialist
- Longwood, FL
National Provider Identifier
1780980797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 196-13069
- Practice address
- 1464 Northridge Dr
Longwood, FL 32750-4548 - Phone
- (407) 325-7926
- NPI assigned
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5154846 | FL | |
| Specialist | 174400000X | 196-13069 | FL | Primary |
Addresses
Primary practice location
1464 Northridge Dr
Longwood, FL 32750-4548
Mailing address
1464 Northridge Dr
Longwood, FL 32750-4548
Phone (407) 325-7926
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN5154846 | FL | MD | Licensed Practical Nurse |
| 196-13069 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1780980797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1464 NORTHRIDGE DR",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504548",
"telephone_number": "407-325-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1464 NORTHRIDGE DR",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504548",
"telephone_number": "407-325-7926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTENUCCI",
"first_name": "DONNA",
"credential": "LPN, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5154846",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "196-13069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.