Provider Demographics
NPI:1598453250
Name:PHILISTIN, CARME SUZE (FNP)
Entity Type:Individual
Prefix:
First Name:CARME SUZE
Middle Name:
Last Name:PHILISTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 18TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-5571
Mailing Address - Country:US
Mailing Address - Phone:239-258-5310
Mailing Address - Fax:
Practice Address - Street 1:801 ANCHOR RODE DR STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2742
Practice Address - Country:US
Practice Address - Phone:239-610-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023706363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily