Individual
MRS. CARRIE ANN ERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED AGENT
Contact information
Practice address
29750 US HIGHWAY 19 N, SUITE 203, CLEARWATER, FL 33761-1510
(727) 282-1075
Mailing address
29750 US HIGHWAY 19 N, SUITE 203, CLEARWATER, FL 33761-1510
(727) 282-1075
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
W085957
FL
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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