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General NPI Number Information
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NPI Number | 1376049213
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Entity Type | Individual
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Provider Name | PHILIP AUSTIN CARNEVALE MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 03/31/2018
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 5105 BOWDEN RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216
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Country | US
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Telephone | 352-870-4661
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Fax | 904-212-2227
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Provider Business Mailing Address
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Address Line | 5105 BOWDEN RD STE 3
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5907
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Country | US
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Telephone | 904-609-3349
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Fax | 904-212-2227
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 9333709
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9333709
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License Number State | FL
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