Provider Demographics
NPI:1942281233
Name:MULLER CARIOBA, JOANNA C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:C
Last Name:MULLER CARIOBA
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 1:12730 NEW BRITTANY BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4690
Mailing Address - Country:US
Mailing Address - Phone:239-275-5522
Mailing Address - Fax:239-275-4464
Practice Address - Street 1:1255 VISCAYA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3290
Practice Address - Country:US
Practice Address - Phone:239-574-1988
Practice Address - Fax:239-574-1435
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85188207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264380400Medicaid
FL000013683GOtherHUMANA
FL13801OtherBC/BS OF FLORIDA
FL000013683GOtherHUMANA
FL264380400Medicaid
FL201146OtherSTAYWELL
FL13801ZMedicare ID - Type Unspecified