Provider Demographics
NPI:1285650499
Name:GRIFFITHS, CAROL (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:GRIFFITHS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 GRAND CANYON DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4353
Mailing Address - Country:US
Mailing Address - Phone:813-979-3562
Mailing Address - Fax:813-979-3536
Practice Address - Street 1:10770 N 46TH ST
Practice Address - Street 2:C-100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-3442
Practice Address - Country:US
Practice Address - Phone:813-979-3562
Practice Address - Fax:813-979-3536
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN752702363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health