Healthcare Provider Details

I. General information

NPI: 1487902771
Provider Name (Legal Business Name): CAROLYN FRANCESCA MOLLO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN O'MALLEY

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 10/04/2023
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S. OLD DIXIE HWY JUPITER MEDICAL CENTER
JUPITER FL
33458
US

IV. Provider business mailing address

1176 DAKOTA DRIVE
JUPITER FL
33458
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-4978
  • Fax: 772-223-2847
Mailing address:
  • Phone: 772-781-2799
  • Fax: 772-781-2716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberARNP9310411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: