Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME76471 | FL |
NPI | 1003818378 |
---|---|
Provider Name | Dr. Carolyn Louise Marasco |
First Address | Clearwater, FL 33757-8744 |
Second Address | Tampa, FL 33618-4404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 05/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
260414100 | (05) | FL |