Healthcare Provider Details

I. General information

NPI: 1144144296
Provider Name (Legal Business Name): CAROLINA CARUCCI MCGUANE MS, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6373 SW 87TH LN
MIAMI FL
33156-1366
US

IV. Provider business mailing address

6373 SW 87TH LN
MIAMI FL
33156-1366
US

V. Phone/Fax

Practice location:
  • Phone: 305-317-2930
  • Fax:
Mailing address:
  • Phone: 305-317-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND15325
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: