Healthcare Provider Details

I. General information

NPI: 1932437985
Provider Name (Legal Business Name): ANNA CARPENTER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SE 17TH ST SUITE 300
FORT LAUDERDALE FL
33316-2550
US

IV. Provider business mailing address

300 SE 17TH ST SUITE 300
FORT LAUDERDALE FL
33316-2550
US

V. Phone/Fax

Practice location:
  • Phone: 954-468-3080
  • Fax: 954-468-3082
Mailing address:
  • Phone: 954-468-3080
  • Fax: 954-468-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: