Provider Demographics
NPI:1295708006
Name:CARPINO, MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CARPINO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0746
Mailing Address - Country:US
Mailing Address - Phone:772-288-6300
Mailing Address - Fax:772-288-6374
Practice Address - Street 1:506 SOUTHWEST FEDERAL HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-288-6300
Practice Address - Fax:772-288-6374
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9104947OtherLICENSE
TNTN681OtherSTATE
TNTN681OtherSTATE
FLPA9104947OtherLICENSE
FLCA917Medicare PIN