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General NPI Number Information
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NPI Number | 1851058655
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Entity Type | Individual
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Provider Name | MADELEINE KNOWLTON CARROLL
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Gender | Female
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 6200 SW 73RD ST # 69
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4679
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Country | US
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Telephone | 786-204-4620
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 BRICKELL AVE APT 2809
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City | MIAMI
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State | FL
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Zip | 33131-3924
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Country | US
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Telephone | 813-601-3734
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11016634
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License Number State | FL
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