Provider Demographics
NPI:1356702997
Name:EXTRA, CARMANTE (DNP, ARNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CARMANTE
Middle Name:
Last Name:EXTRA
Suffix:
Gender:
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1002
Mailing Address - Country:US
Mailing Address - Phone:305-243-1885
Mailing Address - Fax:
Practice Address - Street 1:8100 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3279
Practice Address - Country:US
Practice Address - Phone:954-210-1190
Practice Address - Fax:954-210-1085
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3360182363LF0000X
FLARNP3360182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily