Provider Demographics
NPI:1831689827
Name:GAULDEN, CAROLYN MARIE (MD, MBA, MSW)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MARIE
Last Name:GAULDEN
Suffix:
Gender:F
Credentials:MD, MBA, MSW
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Mailing Address - Street 1:560 JACKSON ST N STE 302
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1449
Mailing Address - Country:US
Mailing Address - Phone:727-849-4063
Mailing Address - Fax:727-816-1726
Practice Address - Street 1:560 JACKSON ST N STE 302
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1449
Practice Address - Country:US
Practice Address - Phone:727-849-4063
Practice Address - Fax:727-816-1726
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1550712084P0800X
MI43015029722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry