Healthcare Provider Details

I. General information

NPI: 1669184818
Provider Name (Legal Business Name): CARON ELAINE SEWARD REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 41ST STREET OCEAN
MARATHON FL
33050-2373
US

IV. Provider business mailing address

3000 41ST STREET OCEAN
MARATHON FL
33050-2373
US

V. Phone/Fax

Practice location:
  • Phone: 786-652-7526
  • Fax: 305-434-7660
Mailing address:
  • Phone: 786-652-7526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR046927
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: