Healthcare Provider Details

I. General information

NPI: 1427521756
Provider Name (Legal Business Name): DARLENE CAULDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 N LECANTO HWY
BEVERLY HILLS FL
34465-3507
US

IV. Provider business mailing address

4354 S LECANTO HWY
LECANTO FL
34461-9032
US

V. Phone/Fax

Practice location:
  • Phone: 844-797-8425
  • Fax:
Mailing address:
  • Phone: 478-972-7021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number249017
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11023567
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11023567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: