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General NPI Number Information
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NPI Number | 1013107994
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Entity Type | Individual
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Provider Name | CAROL L LIVELLI ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 14430 US HIGHWAY 1 SUITE 101
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City | SEBASTIAN
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State | FL
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Zip | 32958-3289
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Country | US
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Telephone | 772-581-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 14430 US HIGHWAY 1 SUITE 101
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City | SEBASTIAN
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State | FL
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Zip | 32958-3289
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Country | US
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Telephone | 772-581-0478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | NP18734
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9313619
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License Number State | FL
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