Healthcare Provider Details

I. General information

NPI: 1417300492
Provider Name (Legal Business Name): CARLY STRONG A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21644 STATE ROAD 7
BOCA RATON FL
33428-1842
US

IV. Provider business mailing address

4280 SAINT CHARLES WAY
BOCA RATON FL
33434-5359
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-8000
  • Fax:
Mailing address:
  • Phone: 561-488-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9280538
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9280538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: