MEDICARE: DR. CAROLE KAY EARLY M.D.

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	207Q00000X	Family Medicine Physician	ME0036611	FL

General Provider Information

NPI Number	:	1790787893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLE KAY EARLY M.D.

Provider Business Mailing Address
First Line	:	740 LAKE AVE
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-2243
Country	:	US
Telephone Number	:	352-243-6900
Fax Number	:	352-243-6902

Provider Business Practice Location Address
First Line	:	740 LAKE AVE
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-2243
Country	:	US
Telephone Number	:	352-243-6900
Fax Number	:	352-243-6902

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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