Healthcare Provider Details

I. General information

NPI: 1003804295
Provider Name (Legal Business Name): CARRIE E VERHOFF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 E GRAND HWY
CLERMONT FL
34711-3708
US

IV. Provider business mailing address

706 E GRAND HWY
CLERMONT FL
34711-3708
US

V. Phone/Fax

Practice location:
  • Phone: 352-557-4965
  • Fax: 352-404-6955
Mailing address:
  • Phone: 352-557-4965
  • Fax: 352-404-6955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP1877272
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: