Individual
JAQUELINE SOUSA CARVALHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12651 WHITEHALL DR, FORT MYERS, FL 33907-3626
(239) 424-2030
(239) 343-4117
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-7130
(239) 343-7185
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
APRN11033857
FL
363L00000X
Nurse Practitioner
Primary
APRN11033857
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125563500
—
FL
Enumeration date
08/21/2024
Last updated
02/07/2025
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