Provider Demographics
NPI:1003861444
Name:CAIN, CAROLYN S (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:CAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1500 SE 17TH ST
Mailing Address - Street 2:# 600
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4621
Mailing Address - Country:US
Mailing Address - Phone:352-732-8955
Mailing Address - Fax:352-732-7999
Practice Address - Street 1:1500 SE 17TH ST
Practice Address - Street 2:# 600
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4621
Practice Address - Country:US
Practice Address - Phone:352-732-8955
Practice Address - Fax:352-732-7999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME00716362080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63235Medicare UPIN