MEDICARE: MR. JAMES CARR LPN

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	164W00000X	Licensed Practical Nurse	1163731	FL

General Provider Information

NPI Number	:	1710202726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES CARR LPN

Provider Business Mailing Address
First Line	:	5022 DEMOTT CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-7626
Country	:	US
Telephone Number	:	407-222-9149
Fax Number	:

Provider Business Practice Location Address
First Line	:	5022 DEMOTT CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-7626
Country	:	US
Telephone Number	:	407-222-9149
Fax Number	:

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

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	04/01/2010

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