Provider Demographics
NPI:1851093421
Name:FALISZEWSKI, CARMELLA A (LPN, AA)
Entity Type:Individual
Prefix:
First Name:CARMELLA
Middle Name:A
Last Name:FALISZEWSKI
Suffix:
Gender:F
Credentials:LPN, AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 WYCLIFFE ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6528
Mailing Address - Country:US
Mailing Address - Phone:689-248-3088
Mailing Address - Fax:
Practice Address - Street 1:1123 WYCLIFFE ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-6528
Practice Address - Country:US
Practice Address - Phone:689-248-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5207531164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPN5207531OtherFLORIDA BOARD OF NURSING