Provider Demographics
NPI:1407321300
Name:COCO, CAREY (APRN, FNP, RN)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:COCO
Suffix:
Gender:F
Credentials:APRN, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4191
Mailing Address - Country:US
Mailing Address - Phone:863-298-0670
Mailing Address - Fax:863-298-3200
Practice Address - Street 1:635 FIRST STREET, NORTH
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4129
Practice Address - Country:US
Practice Address - Phone:863-298-0670
Practice Address - Fax:863-298-3200
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9243855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily