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NPI Code Detail

MEDICARE: CARLA M GRANT APRN

MEDICARE: CARLA M GRANT APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner2171048ID
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5021447NC
3363LP0808XPsychiatric/Mental Health Nurse Practitioner1183751TX
4363LP0808XPsychiatric/Mental Health Nurse PractitionerAP61644382WA
5363LP0808XPsychiatric/Mental Health Nurse Practitioner95034975CA
6363LP0808XPsychiatric/Mental Health Nurse PractitionerG182531IA
7363LP0808XPsychiatric/Mental Health Nurse Practitioner0024192164VA
8363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11027939FL
9363LP0808XPsychiatric/Mental Health Nurse Practitioner12.014313CT

General Provider Information

NPI Number : 1447035605
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA M GRANT APRN
Provider Business Mailing Address
First Line : 1065 NE 125TH ST STE 300
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33161-5833
Country : US
Telephone Number : 305-891-0050
Fax Number : 305-891-4228
Provider Business Practice Location Address
First Line : 10301 HAGEN RANCH RD STE B200
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-3723
Country : US
Telephone Number : 561-752-9490
Fax Number : 561-752-9491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 12/08/2025

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