Provider Demographics
NPI:1548635782
Name:CARMONA, CHRISTINA (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CARMONA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 NW 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2902
Mailing Address - Country:US
Mailing Address - Phone:954-864-9184
Mailing Address - Fax:
Practice Address - Street 1:1127 NW 133RD AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2902
Practice Address - Country:US
Practice Address - Phone:954-864-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-13
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily