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General NPI Number Information
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NPI Number | 1740766641
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Entity Type | Individual
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Provider Name | HALEY ELIZABETH MARIE CARPENTER MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2855 N UNIVERSITY DR STE 400
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-1408
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Country | US
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Telephone | 561-235-0942
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 N UNIVERSITY DR STE 400
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-1408
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Country | US
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Telephone | 904-861-4153
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | ME164929
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License Number State | FL
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