Provider Demographics
NPI:1568503415
Name:CEDERQUIST, CAROLINE JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:JOY
Last Name:CEDERQUIST
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1575 PINE RIDGE RD
Mailing Address - Street 2:#19
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2107
Mailing Address - Country:US
Mailing Address - Phone:239-593-0663
Mailing Address - Fax:239-593-0664
Practice Address - Street 1:1575 PINE RIDGE RD
Practice Address - Street 2:#19
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2107
Practice Address - Country:US
Practice Address - Phone:239-593-0663
Practice Address - Fax:239-593-0664
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME71924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF38581Medicare UPIN