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General NPI Number Information
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NPI Number | 1073547543
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Entity Type | Individual
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Provider Name | KENNETH O. CARTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 1000 BAY PINES BLVD.
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City | BAY PINES
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-273-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 235 3RD AVE N UNIT 551
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3383
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Country | US
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Telephone | 704-953-8039
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME127103
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License Number State | FL
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