Provider Demographics
NPI:1811716954
Name:DARTHARD, CARISMA
Entity type:Individual
Prefix:
First Name:CARISMA
Middle Name:
Last Name:DARTHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10988 RAVEL CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6747
Mailing Address - Country:US
Mailing Address - Phone:863-214-8455
Mailing Address - Fax:
Practice Address - Street 1:10988 RAVEL CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6747
Practice Address - Country:US
Practice Address - Phone:863-214-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9507013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse