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General NPI Number Information
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NPI Number | 1225057375
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Entity Type | Individual
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Provider Name | ANDREA ELLEN CARTER O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4001 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34997-4909
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Country | US
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Telephone | 772-283-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 8545 SE PALM ST
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City | HOBE SOUND
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State | FL
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Zip | 33455-2928
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Country | US
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Telephone | 561-371-4585
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Fax | 772-283-2751
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2022
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License Number State | FL
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