MEDICARE: MRS. CARRIE SHUMPERT FALOWSKI 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
1	363LF0000X	Family Nurse Practitioner	APRN9301660	FL
2	363LA2100X	Acute Care Nurse Practitioner	30512	SC
3	363LA2100X	Acute Care Nurse Practitioner	APRN9301660	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	:	1962035477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE SHUMPERT FALOWSKI APRN

Provider Business Mailing Address
First Line	:	3141 SW 20TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3731
Country	:	US
Telephone Number	:	954-829-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	7369 SHERIDAN ST STE 302
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2776
Country	:	US
Telephone Number	:	954-276-1925
Fax Number	:	954-276-0675

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

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	02/11/2026

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