Provider Demographics
NPI:1902250459
Name:DICARLO, GINA M (CNIM)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:DICARLO
Suffix:
Gender:F
Credentials:CNIM
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Mailing Address - Street 1:302 HARBOUR PLACE DR APT 3218
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6761
Mailing Address - Country:US
Mailing Address - Phone:610-299-2378
Mailing Address - Fax:
Practice Address - Street 1:2150 TOWN SQUARE PL STE 290
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1643
Practice Address - Country:US
Practice Address - Phone:281-768-6730
Practice Address - Fax:281-768-6766
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-09-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic