Provider Demographics
NPI:1457381840
Name:HARRINGTON, CAROLYN CASWELL (RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:CASWELL
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 RIO TERRA
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2949
Mailing Address - Country:US
Mailing Address - Phone:941-882-3071
Mailing Address - Fax:941-882-3071
Practice Address - Street 1:217 RIO TERRA
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2949
Practice Address - Country:US
Practice Address - Phone:941-882-3071
Practice Address - Fax:941-882-3071
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI354133V00000X
FLND5819133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000371805Medicare ID - Type Unspecified
WI001039270Medicare ID - Type Unspecified