Provider Demographics
NPI:1053838235
Name:WESLEY, CARMEN DENISE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:DENISE
Last Name:WESLEY
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 1:4336 SW 124TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6011
Mailing Address - Country:US
Mailing Address - Phone:305-409-7166
Mailing Address - Fax:
Practice Address - Street 1:20950 NE 27TH CT STE 200
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1232
Practice Address - Country:US
Practice Address - Phone:305-466-0663
Practice Address - Fax:305-466-0663
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9226358363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care