Provider Demographics
NPI:1346372083
Name:CARULLI, DENISE MAGALY (ARNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MAGALY
Last Name:CARULLI
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 1:12470 TELECOM DR
Mailing Address - Street 2:STE 300W
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637
Mailing Address - Country:US
Mailing Address - Phone:813-871-8079
Mailing Address - Fax:
Practice Address - Street 1:12470 TELECOM DR
Practice Address - Street 2:STE 300W
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637
Practice Address - Country:US
Practice Address - Phone:813-871-8079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3172932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 3172932OtherADV REG NURSE PRACTITIONE