Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 51168 | FL |
NPI | 1083712418 |
---|---|
Provider Name | Dr. Carolyn Schroeder Connelly |
First Address | Tampa, FL 33609-4052 |
Second Address | Tampa, FL 33609-4052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 01/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08533 | (02) | FL |