Healthcare Provider Details

I. General information

NPI: 1265310908
Provider Name (Legal Business Name): CAROLINE RENEE MONROE APNR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 PORTER ST
SAINT GEORGE ISLAND FL
32328-2456
US

IV. Provider business mailing address

PO BOX 681
EASTPOINT FL
32328-0681
US

V. Phone/Fax

Practice location:
  • Phone: 850-227-5255
  • Fax:
Mailing address:
  • Phone: 850-227-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11041625
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: