Provider Demographics
NPI:1023260643
Name:CARMONA, CORINNE ANN (APN)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:ANN
Last Name:CARMONA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 LAKEFRONT DR UNIT 3412
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1608
Mailing Address - Country:US
Mailing Address - Phone:201-506-3473
Mailing Address - Fax:
Practice Address - Street 1:13770 PLANTATION RD # 103
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4460
Practice Address - Country:US
Practice Address - Phone:941-444-0011
Practice Address - Fax:603-952-3900
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021115363LF0000X, 363L00000X
NJ26NN08805600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner