Provider Demographics
NPI:1306977962
Name:CAUGHRAN, CAROL ANN (MSED)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:CAUGHRAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:VENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5307 NW 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3203
Mailing Address - Country:US
Mailing Address - Phone:954-240-4055
Mailing Address - Fax:
Practice Address - Street 1:4700 N STATE ROAD 7
Practice Address - Street 2:#211
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5800
Practice Address - Country:US
Practice Address - Phone:954-485-8888
Practice Address - Fax:957-497-3857
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator