Provider Demographics
NPI:1740656867
Name:CARTER, BRENT ELLIOTT (DPM)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:ELLIOTT
Last Name:CARTER
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5940 N BONVIEW PT
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-8267
Mailing Address - Country:US
Mailing Address - Phone:352-388-4680
Mailing Address - Fax:352-304-6898
Practice Address - Street 1:1714 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1227
Practice Address - Country:US
Practice Address - Phone:352-388-4680
Practice Address - Fax:352-304-6898
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3933213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFC6222943OtherDEA