MEDICARE: MS. ANITA M CARTER MSW

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	1041C0700X	Clinical Social Worker	5080	SC

General Provider Information

NPI Number	:	1598746851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANITA M CARTER MSW

Provider Business Mailing Address
First Line	:	11401 DR. MLK JR. ST N APT 409
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33716
Country	:	US
Telephone Number	:	803-491-4075
Fax Number	:

Provider Business Practice Location Address
First Line	:	10000 BAY PINES BLVD
Second Line	:
City	:	BAY PINES
State	:	FL
Zip	:	33744-8200
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	06/16/2016

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