Provider Demographics
NPI:1356967830
Name:NEDDO-IRAHETA, CARINA KATHLEEN (APRN, FNP-BC, NP-C)
Entity type:Individual
Prefix:MRS
First Name:CARINA
Middle Name:KATHLEEN
Last Name:NEDDO-IRAHETA
Suffix:
Gender:F
Credentials:APRN, FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6663 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3953
Mailing Address - Country:US
Mailing Address - Phone:561-329-9166
Mailing Address - Fax:
Practice Address - Street 1:6663 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-3953
Practice Address - Country:US
Practice Address - Phone:561-329-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily