Provider Demographics
NPI:1417439472
Name:TSUR, CARYN ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CARYN
Middle Name:ANN
Last Name:TSUR
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 1:10115 FOREST HILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3104
Mailing Address - Country:US
Mailing Address - Phone:561-795-0016
Mailing Address - Fax:561-795-5557
Practice Address - Street 1:10115 FOREST HILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3104
Practice Address - Country:US
Practice Address - Phone:561-795-0016
Practice Address - Fax:561-795-5557
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9365743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty