Provider Demographics
NPI:1477857621
Name:DESIR, CARLESA (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLESA
Middle Name:
Last Name:DESIR
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 1:10450 TURKEY LAKE RD
Mailing Address - Street 2:#691483
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-7501
Mailing Address - Country:US
Mailing Address - Phone:407-230-2108
Mailing Address - Fax:
Practice Address - Street 1:10450 TURKEY LAKE RD
Practice Address - Street 2:#691483
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32869-7501
Practice Address - Country:US
Practice Address - Phone:407-230-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9246168363LF0000X, 363LG0600X, 363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1477857621OtherNPI
FLARNP9246168OtherLICENSE
FLARNP9246168OtherLICENSE