Healthcare Provider Details

I. General information

NPI: 1447269238
Provider Name (Legal Business Name): JOHN CARTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 W SWANN AVE STE 402
TAMPA FL
33609-4083
US

IV. Provider business mailing address

2255 GLADES RD STE 228W
BOCA RATON FL
33431-7391
US

V. Phone/Fax

Practice location:
  • Phone: 813-696-1681
  • Fax: 813-696-1703
Mailing address:
  • Phone: 813-696-1681
  • Fax: 813-696-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME74849
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: