Provider Demographics
NPI:1497187751
Name:HUNT, CAROLYN LORRAINE
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LORRAINE
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SE 20TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2747
Mailing Address - Country:US
Mailing Address - Phone:239-574-8994
Mailing Address - Fax:239-574-8994
Practice Address - Street 1:205 SE 20TH CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2747
Practice Address - Country:US
Practice Address - Phone:239-574-8994
Practice Address - Fax:239-574-8994
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6905492311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home