Individual
CARRIE ALISON TEAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2368 N RIVERSIDE DR, INDIALANTIC, FL 32903-3619
(321) 543-8778
Mailing address
2368 N RIVERSIDE DR, INDIALANTIC, FL 32903-3619
(321) 543-8778
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME45861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060004271
RAIL ROAD MEDICARE
—
05
—
266194200
—
FL
Enumeration date
04/18/2006
Last updated
04/29/2016
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