Healthcare Provider Details

I. General information

NPI: 1902053812
Provider Name (Legal Business Name): CAROLYN M. CAREY, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 S PARSONS AVE
BRANDON FL
33511-6063
US

IV. Provider business mailing address

880 6TH ST S SUITE 310
ST PETERSBURG FL
33701-4827
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-8181
  • Fax:
Mailing address:
  • Phone: 727-767-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN M CAREY
Title or Position: PRESIDENT
Credential: MD
Phone: 727-767-8181