Provider Demographics
NPI:1457438806
Name:BARTHOLOMEW, CAROL ANN (DCDACAN)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:DCDACAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4433
Mailing Address - Country:US
Mailing Address - Phone:352-351-5343
Mailing Address - Fax:352-368-1099
Practice Address - Street 1:420 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4433
Practice Address - Country:US
Practice Address - Phone:352-351-5343
Practice Address - Fax:352-368-1099
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003848111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0502146-00Medicaid
FL0502146-00Medicaid
FL88828Medicare PIN