Provider Demographics
NPI:1952495640
Name:MCCARTER, ELAINE MARIE (CPHT)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:MARIE
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7588 CENTRAL PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-5741
Mailing Address - Country:US
Mailing Address - Phone:813-989-2124
Mailing Address - Fax:
Practice Address - Street 1:9535 EAST FOWLER AV.
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-2139
Practice Address - Country:US
Practice Address - Phone:813-986-0788
Practice Address - Fax:813-986-9607
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL260101030761241183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050001Medicare ID - Type Unspecified