Provider Demographics
NPI:1154394435
Name:RHODES, CAROL M (ARNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:RHODES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 21ST AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7847
Mailing Address - Country:US
Mailing Address - Phone:941-761-4448
Mailing Address - Fax:941-761-0235
Practice Address - Street 1:6001 21ST AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7847
Practice Address - Country:US
Practice Address - Phone:941-761-4448
Practice Address - Fax:941-761-0235
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3120242363L00000X
NMCNP 02208363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P35647Medicare UPIN
E5842YMedicare ID - Type Unspecified