Provider Demographics
NPI:1972792216
Name:NEVINE M CARP MD PA
Entity Type:Organization
Organization Name:NEVINE M CARP MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEVINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARP
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:561-374-7911
Mailing Address - Street 1:2623 S SEACREST BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7532
Mailing Address - Country:US
Mailing Address - Phone:561-374-7911
Mailing Address - Fax:561-734-8104
Practice Address - Street 1:2623 S SEACREST BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7532
Practice Address - Country:US
Practice Address - Phone:561-374-7911
Practice Address - Fax:561-734-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80077207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258944300Medicaid
FL258944300Medicaid
FLAG666Medicare UPIN