| Doctor Name: | MS. DIANE LYNNE RACCIO |
| NPI Number: | 1053578377 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, ANP-BC |
| License Number: | 003797 |
| Business Practice Address: | 4161 Tamiami Trl Suite 201 Port Charlotte, FL - 339529204 |
| Business Phone Number: | 9417640800 |
| Business Fax Number: | 9417646494 |
| Mailing Address: | 4161 Tamiami Trl, Suite 201 PORT CHARLOTTE |
| State: | FL |
| Postal Code: | 339529204 |
| Phone Number: | 9417640800 |
| Fax Number: | 9417646494 |
| NPI Enumeration Date: | 05/22/2008 |
| NPI Last Update Date: | 10/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 003797 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |