Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 9225498 | FL |
NPI | 1003177650 |
---|---|
Provider Name | Mrs. Carmelle Alexis Casimir |
First Address | North Lauderdale, FL 33068-2547 |
Second Address | North Lauderdale, FL 33068-2547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 30/05/2012 |