Provider Demographics
NPI:1518152396
Name:CAREN CENTER II
Entity Type:Organization
Organization Name:CAREN CENTER II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-924-1363
Mailing Address - Street 1:6981 CURTISS AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8100
Mailing Address - Country:US
Mailing Address - Phone:941-924-1363
Mailing Address - Fax:941-921-6379
Practice Address - Street 1:6981 CURTISS AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8100
Practice Address - Country:US
Practice Address - Phone:941-924-1363
Practice Address - Fax:941-921-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME000436207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1567Medicare PIN