Provider Demographics
NPI:1952867004
Name:WHITE, CAROLYN ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7169 HEMLOCK LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-2176
Mailing Address - Country:US
Mailing Address - Phone:352-687-0148
Mailing Address - Fax:352-687-0213
Practice Address - Street 1:7169 HEMLOCK LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2176
Practice Address - Country:US
Practice Address - Phone:352-687-0148
Practice Address - Fax:352-687-0213
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW300-105-48-751-0OtherFLORIDA DRIVER LIC NUMBER
FLW300-105-48-751-0OtherFL DRIVERS LIC #