Provider Demographics
NPI:1487902771
Name:MOLLO, CAROLYN FRANCESCA (ARNP)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:FRANCESCA
Last Name:MOLLO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:O'MALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1176 DAKOTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:772-781-2799
Mailing Address - Fax:772-781-2716
Practice Address - Street 1:1210 S. OLD DIXIE HWY JUPITER MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:772-223-4978
Practice Address - Fax:772-223-2847
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9310411363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGM406ZMedicare PIN