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Individual

DR. MARY TERESE CARBONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
13601 PLANTATION ROAD, FORT MYERS, FL 33912
(239) 343-0762
(239) 343-0958
Mailing address
P.O. BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-1449
(239) 424-1421

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
25MA05494700
NJ
2080S0012X
Pediatric Sleep Medicine Physician
25MA05494700
NJ
2080S0012X
Pediatric Sleep Medicine Physician
Primary
ME74786
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2061406
NJ
Enumeration date
05/18/2006
Last updated
08/01/2018
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