Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ARNP9173953 | FL |
NPI | 1164754628 |
---|---|
Provider Name | Miss Carianne Fiona Dennis |
First Address | Greenacres, FL 33463-3480 |
Second Address | Boca Raton, FL 33431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2010 |
Last Update Date | 02/01/2018 |