Provider Demographics
NPI:1003264201
Name:CARNEVALE, FELICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:CARNEVALE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 RIVIERA ST STE D
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2827
Mailing Address - Country:US
Mailing Address - Phone:941-244-9524
Mailing Address - Fax:941-244-9526
Practice Address - Street 1:517 RIVIERA ST STE D
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285
Practice Address - Country:US
Practice Address - Phone:941-244-9524
Practice Address - Fax:941-244-9526
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9311825363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health