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General NPI Number Information
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NPI Number | 1629005244
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Entity Type | Individual
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Provider Name | LAURETTE M DICARLO ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6399 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1647
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Country | US
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Telephone | 727-384-6411
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Fax | 727-384-9033
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Provider Business Mailing Address
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Address Line | 11349 110TH TERR N
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City | LARGO
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State | FL
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Zip | 33778-3708
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Country | US
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Telephone | 727-393-9821
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Fax | 727-393-9821
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP 1364582
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License Number State | FL
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