Provider Demographics
NPI:1063510329
Name:FLEENER, CAROLA HOIGNE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLA
Middle Name:HOIGNE
Last Name:FLEENER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 BEE RIDGE ROAD
Mailing Address - Street 2:BLDG A SUITE C
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-923-3667
Mailing Address - Fax:941-924-3246
Practice Address - Street 1:3920 BEE RIDGE RD BLDG A STE C
Practice Address - Street 2:SARASOTA CHILDRENS CLINIC PA
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-923-3667
Practice Address - Fax:941-924-3246
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52202208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062448900Medicaid
FL37786650OtherMEDIPASS