Provider Demographics
NPI:1629131594
Name:DESPINOS, CARINE M (ARNP)
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:M
Last Name:DESPINOS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5646
Practice Address - Street 1:3498 NW FEDERAL HWY
Practice Address - Street 2:SUITE C
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4441
Practice Address - Country:US
Practice Address - Phone:772-223-5777
Practice Address - Fax:772-223-4949
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1530342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY00MSOtherFLORIDA BLUE
FL308289000Medicaid
FLY00MSOtherFLORIDA BLUE