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General NPI Number Information
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NPI Number | 1770376436
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Entity Type | Individual
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Provider Name | DEVONI' I CARPENTER
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 245 RIVERSIDE AVENUE SUITE 100 PMB1030
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City | JACKSONVILLE
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State | FL
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Zip | 32202
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Country | US
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Telephone | 850-852-0843
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Fax | 904-341-5018
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Provider Business Mailing Address
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Address Line | 245 RIVERSIDE AVENUE SUITE 100 PMB1030
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City | JACKSONVILLE
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State | FL
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Zip | 32202
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Country | US
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Telephone | 850-852-0843
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Fax | 904-341-5018
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 6229519527DC
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License Number State | FL
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