Provider Demographics
NPI:1982010096
Name:KEATING, CARA
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:
Last Name:KEATING
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:CARA
Other - Middle Name:LYNN
Other - Last Name:STURLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:689 E ALTAMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4801
Mailing Address - Country:US
Mailing Address - Phone:407-767-7262
Mailing Address - Fax:
Practice Address - Street 1:689 E ALTAMONTE DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4801
Practice Address - Country:US
Practice Address - Phone:407-767-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107987363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104812400Medicaid