Provider Demographics
NPI:1760401715
Name:CARTER, JOAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 BRUCE B, DOWNS BOULEVARD
Mailing Address - Street 2:JAMES A. HALEY VETERANS HOSPITAL
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-998-8000
Mailing Address - Fax:813-971-2429
Practice Address - Street 1:13000 BRUCE B, DOWNS BOULEVARD
Practice Address - Street 2:JAMES A. HALEY VETERANS HOSPITAL
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-998-8000
Practice Address - Fax:813-971-2429
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME037600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592796929OtherHUMANA
FL592796929OtherHUMANA
FLD67321Medicare UPIN