Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH0003848 | FL |
NPI | 1457438806 |
---|---|
Provider Name | Mrs. Carol Ann Bartholomew |
First Address | Ocala, FL 34471-4433 |
Second Address | Ocala, FL 34471-4433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 24/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0502146-00 | (05) | FL |
1344665 | (02) | FL |