Carlene D. Waters-Hollingsworth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104786 Issued in FL

Practice address

10000 W Colonial Dr Ste 495
Ocoee, FL 34761-3436

Phone

(407) 293-5944

Fax

(407) 293-7355

NPI assigned

May 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1083665459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 495",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613436",
            "telephone_number": "407-293-5944",
            "fax_number": "407-293-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 495",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613436",
            "telephone_number": "407-293-5944",
            "fax_number": "407-293-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS-HOLLINGSWORTH",
        "first_name": "CARLENE",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052039",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104786",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104786",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph Wall III, M.D.
• Brianna R Wallace
• Keith Wandolowski, CRNA
• Catherine Wang, MD
• Chad Michael Ward, APRN
• Francine Chery Watkins III
• Brandy L Watters, LMT
• Chris J Wehr, MD
• Wellness Health Acupuncture & Physical Therapy
• Charles Francis Wennogle Jr., MD

• Physician Assistant in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.