Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN11013380 | FL |
NPI | 1023686672 |
---|---|
Provider Name | Cynthia Daniel Carter |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901-1973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2021 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110924400 | (05) | FL |
NZ737 | MEDICARE (01) | FL |