Individual
MS. CAROLINA COLETTE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4750 LINCOLN BLVD APT 183, MARINA DEL REY, CA 90292-6982
(305) 215-0932
Mailing address
1044 JEFFERY ST, BOCA RATON, FL 33487-4185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9110052
FL
Other
Enumeration date
06/07/2016
Last updated
08/06/2019
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