Provider Demographics
NPI:1902814197
Name:SYLVESTER, CARMEN M (ARNP)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:M
Last Name:SYLVESTER
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 1:643 CAPE CORAL PKWY E STE B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-8549
Mailing Address - Country:US
Mailing Address - Phone:239-257-3094
Mailing Address - Fax:239-471-2870
Practice Address - Street 1:643 CAPE CORAL PKWY E STE B
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8549
Practice Address - Country:US
Practice Address - Phone:239-257-3094
Practice Address - Fax:239-471-2870
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2786032363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP448ZOtherMEDICARE PTAN
FL305398900Medicaid
P00716159OtherRR MEDICARE
FL305398900Medicaid