Provider Demographics
NPI:1740356484
Name:ZAWID, CAROLE SUE (APRN, PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:SUE
Last Name:ZAWID
Suffix:
Gender:F
Credentials:APRN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 ISLAND BLVD
Mailing Address - Street 2:APT 1005
Mailing Address - City:ADVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3761
Mailing Address - Country:US
Mailing Address - Phone:609-226-7601
Mailing Address - Fax:305-749-3255
Practice Address - Street 1:6000 ISLAND BLVD
Practice Address - Street 2:APT 1005
Practice Address - City:ADVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-3761
Practice Address - Country:US
Practice Address - Phone:609-226-7601
Practice Address - Fax:305-749-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC03404800163WP0808X, 364SP0808X
FL11004793364SP0808X
FL9175150364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000468698Medicare ID - Type Unspecified