Individual
CAROLYN J MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN APRN FNP BC
Contact information
Practice address
11322 SE 55TH AVENUE RD UNIT 901, BELLEVIEW, FL 34420-3749
(352) 653-8248
Mailing address
11322 SE 55TH AVENUE RD UNIT 901, BELLEVIEW, FL 34420-3749
(352) 653-8248
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11009364
FL
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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