Healthcare Provider Details
I. General information
NPI: 1891332425
Provider Name (Legal Business Name): MICHELLE DAN EL CARR INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2019
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
902 MARLENE DR
OCOEE FL
34761-3228
US
IV. Provider business mailing address
1317 EDGEWATER DR STE 300
ORLANDO FL
32804-6350
US
V. Phone/Fax
- Phone: 407-435-1965
- Fax:
- Phone: 497-435-1965
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
DAN EL
CARR
Title or Position: CNS
Credential: APRN
Phone: 407-435-1965