MEDICARE: LATOYA MONIQUE CARPENTER

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	363LF0000X	Family Nurse Practitioner	APRN11010666	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639765027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA MONIQUE CARPENTER

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-281-9065
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 W DR MARTIN LUTHER KING JR BLVD STE 203
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6223
Country	:	US
Telephone Number	:	813-872-7737
Fax Number	:	813-443-8120

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

Provider Enumeration Date	:	12/19/2020
Last Update Date	:	12/31/2024

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Directions to “ LATOYA MONIQUE CARPENTER ” Practice Location

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