Provider Demographics
NPI:1003214362
Name:EPSTEIN, CAROLINE BROOKE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:BROOKE
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CAROLINE
Other - Middle Name:BROOKE
Other - Last Name:WISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2884 WELLNESS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8397
Mailing Address - Country:US
Mailing Address - Phone:386-668-2221
Mailing Address - Fax:386-668-2228
Practice Address - Street 1:2884 WELLNESS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8397
Practice Address - Country:US
Practice Address - Phone:386-668-2221
Practice Address - Fax:386-668-2228
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPA9108197363A00000X
FLPA9108197363A00000X, 207RG0100X
GAP007584363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical