Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME148185 | FL |
NPI | 1033165600 |
---|---|
Provider Name | Dr. Patricia Carlin |
First Address | Orlando, FL 32828-7365 |
Second Address | Orlando, FL 32828-4511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 17/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1490555 | (05) | LA |