Individual
JADE LUCIANA CARBONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9170 OAKHURST RD STE 1, SEMINOLE, FL 33776-2112
(813) 321-1786
(813) 321-1787
Mailing address
18228 N US HIGHWAY 41, LUTZ, FL 33549-4400
(813) 321-1786
(813) 321-1787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
08/26/2024
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