MEDICARE: CAROL ANN CAUGHRAN M.S.ED

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1306977962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ANN CAUGHRAN M.S.ED

Provider Business Mailing Address
First Line	:	5307 NW 49TH AVE
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-3203
Country	:	US
Telephone Number	:	954-240-4055
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 N STATE ROAD 7
Second Line	:	#211
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5800
Country	:	US
Telephone Number	:	954-485-8888
Fax Number	:	957-497-3857

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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