Individual
DR. CAROLYN D PASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1143 STATE ROAD 60 E, LAKE WALES, FL 33853-4320
(863) 679-8815
(863) 679-8335
Mailing address
1143 STATE ROAD 60 E, LAKE WALES, FL 33853-4320
(863) 679-8815
(863) 679-8335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME73921
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252811800
—
FL
01
—
41992
BCBS
FL
Enumeration date
03/14/2006
Last updated
09/03/2021
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