Provider Demographics
NPI:1770066672
Name:HARRISON, CARMEN ALITZA (ARNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:ALITZA
Last Name:HARRISON
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23276 MIRABELLA CIR N
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6126
Mailing Address - Country:US
Mailing Address - Phone:561-603-3813
Mailing Address - Fax:
Practice Address - Street 1:3501 WEST DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-2000
Practice Address - Country:US
Practice Address - Phone:954-426-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9275222363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner