Provider Demographics
NPI:1891938320
Name:TIBBITS, CAROL W (ARNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:W
Last Name:TIBBITS
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 1:6401 CONGRESS AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2843
Mailing Address - Country:US
Mailing Address - Phone:561-314-0569
Mailing Address - Fax:800-648-5634
Practice Address - Street 1:6401 CONGRESS AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2843
Practice Address - Country:US
Practice Address - Phone:561-314-0569
Practice Address - Fax:800-648-5634
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1204802163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health