=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760347413
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLO EDOUARD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16853 NE 2ND AVE STE 304
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33162-1776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-414-6666
-----------------------------------------------------
Fax | 786-221-3542
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5959 NW 24TH CT
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33313-2932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-709-9040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN11044103
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------