MEDICARE: SONJA K CARSTENS ARNP

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	363LG0600X	Gerontology Nurse Practitioner	ARNP9195484	FL

General Provider Information

NPI Number	:	1790782977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA K CARSTENS ARNP

Provider Business Mailing Address
First Line	:	1136 PINELAND AVE
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34285-7843
Country	:	US
Telephone Number	:	941-484-4705
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 INTERSTATE BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-8685
Country	:	US
Telephone Number	:	941-870-0199
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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