Provider Demographics
NPI:1255380622
Name:ANDERSON, CAROLYN ERIKA (APN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ERIKA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:ERIKA
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:215 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4841
Mailing Address - Country:US
Mailing Address - Phone:305-441-7179
Mailing Address - Fax:
Practice Address - Street 1:215 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-4841
Practice Address - Country:US
Practice Address - Phone:305-441-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9380843282NC2000X
FL9380843363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No282NC2000XHospitalsGeneral Acute Care HospitalChildren