Provider Demographics
NPI:1679890008
Name:ST. VIL, CARLINE (ARNP, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARLINE
Middle Name:
Last Name:ST. VIL
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:MS
Other - First Name:CARLINE
Other - Middle Name:
Other - Last Name:ST. VIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, NP-C
Mailing Address - Street 1:9056 VILLA PORTOFINO CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1752
Mailing Address - Country:US
Mailing Address - Phone:561-716-6035
Mailing Address - Fax:
Practice Address - Street 1:225 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4616
Practice Address - Country:US
Practice Address - Phone:561-279-2665
Practice Address - Fax:561-439-4212
Is Sole Proprietor?:No
Enumeration Date:2010-04-25
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9273829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDI374ZMedicare PIN
FLDI374XMedicare PIN