Active NPI
Carol L Bloomquist Mikulka, M.D.
- Psychiatry Physician
- Winter Park, FL
National Provider Identifier
1124059563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME50632
- Practice address
- 214 Tyree LN
Winter Park, FL 32792-4135 - Phone
- (407) 645-3777
- Fax
- (407) 645-1123
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME50632 | FL | Primary |
Addresses
Primary practice location
214 Tyree LN
Winter Park, FL 32792-4135
Mailing address
214 Tyree LN
Winter Park, FL 32792-4135
Phone (407) 645-3777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME50632 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1124059563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 TYREE LN",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924135",
"telephone_number": "407-645-3777",
"fax_number": "407-645-1123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 TYREE LN",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924135",
"telephone_number": "407-645-3777",
"fax_number": "407-645-1123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOMQUIST MIKULKA",
"first_name": "CAROL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2023-04-10",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME50632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
- Blessings Woman'S Care & Medical Spa
- David Lyle Bloodgood, LMHC
- Charles Stephen Bloom, M.D.
- Jennifer Hanson Bloom, LMFT
- Blooming Behavior Therapy LLC
- Blue Horizon Eating Disorder Services, LLC
- Blue Ocean Deramtology LLC
- David J. Blue, DMD
- Sanford K Boaz, ARNP
- Body Energetics Acupuncture and Wellness
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.