Provider Demographics
NPI:1578911442
Name:DE CARVALHO, MARCIA SOBREIRA (APRN, RN)
Entity Type:Individual
Prefix:
First Name:MARCIA SOBREIRA
Middle Name:
Last Name:DE CARVALHO
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N FEDERAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4611
Mailing Address - Country:US
Mailing Address - Phone:954-771-2111
Mailing Address - Fax:
Practice Address - Street 1:4800 N FEDERAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4611
Practice Address - Country:US
Practice Address - Phone:954-771-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9316643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1710647OtherAANP