MEDICARE: MICHAEL CARPINO 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
1	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA9104947	OTHER	FL	LICENSE
2	TN681	OTHER	TN	STATE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295708006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CARPINO PA-C

Provider Business Mailing Address
First Line	:	PO BOX 746
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34995-0746
Country	:	US
Telephone Number	:	772-288-6300
Fax Number	:	772-288-6374

Provider Business Practice Location Address
First Line	:	1880 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-5545
Country	:	US
Telephone Number	:	772-446-4554
Fax Number	:	772-204-2456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	06/16/2025

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Directions to “ MICHAEL CARPINO PA-C” Practice Location

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