Provider Demographics
NPI:1922847110
Name:SLOANE, CARMEN (BA)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:SLOANE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 EUCALYPTUS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34949-3410
Mailing Address - Country:US
Mailing Address - Phone:561-801-6381
Mailing Address - Fax:
Practice Address - Street 1:1601 NE BRAILLE PL
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-5345
Practice Address - Country:US
Practice Address - Phone:772-320-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty