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NPI Code Detail

MEDICARE: CAITLIN HALLEY CARROLL PA-C

MEDICARE: CAITLIN HALLEY CARROLL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine PhysicianPAT9113697FL

General Provider Information

NPI Number : 1063012086
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN HALLEY CARROLL PA-C
Provider Business Mailing Address
First Line : 1155 LOWELL TER
Second Line :
City : INVERNESS
State : FL
Zip : 34452-6821
Country : US
Telephone Number : 407-506-4515
Fax Number :
Provider Business Practice Location Address
First Line : 1250 N VANTAGE POINT DR
Second Line :
City : CRYSTAL RIVER
State : FL
Zip : 34429-5736
Country : US
Telephone Number : 352-795-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2020
Last Update Date : 07/18/2022

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Directions to “ CAITLIN HALLEY CARROLL PA-C” Practice Location

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