MEDICARE: LORIN A CARROLL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11026721	FL

General Provider Information

NPI Number	:	1548943830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIN A CARROLL APRN

Provider Business Mailing Address
First Line	:	3010 W AZEELE ST STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3577
Country	:	US
Telephone Number	:	813-251-0194
Fax Number	:	813-254-0279

Provider Business Practice Location Address
First Line	:	3010 W AZEELE ST STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3577
Country	:	US
Telephone Number	:	813-251-0194
Fax Number	:	813-254-0279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2023
Last Update Date	:	04/25/2025

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