If you give it fair thought, Carmine's health was never in question for a moment until the stroke and soon after death.

That said, Little Carmine operated in South Florida but do we honestly think he had a crew reporting to him there? He surely had associates, but as we know FLA crews traditionally earn quietly with little muscle as satellite faction's for larger NY crews.

Carmine was obviously direct with his father as far as reporting and thus had a title of Capo most likely, However, his businesses being largely legitimate I think he honestly may have just been quietly earning before he came back to New York. He was openly mocked by all as a widely known idiot until being finally introduced into the series. If you give it thought, he likely was just operating the porn company and other (semi) legitimate businesses with minimum associates to earn legitimately under the radar and stay out of risk, while living the high life in Miami as the son of a NY Boss.

It isn't until Carmine Sr. passes that Little Carmine rallies made Lupertazzi members with the help of Rusty and Angelo to form his faction, although it was widely the faction still loyal to Carmine Sr. reluctant to immediately accept the Sacramoni Faction so soon after Carmine died.

Food for thought to make the point, if Carmine was really operating a crew in Florida not just running personal businesses, why did Beansy have to set up action for Tony and Paulie while they were in the wind for the Willie Overall hit? If Little Carmine had been running a crew, who took it over and why weren't they point of contact for Tony? Surely if there was still a Little Carmine Crew in place Beansy wouldn't have to set up a stolen goods trade with a smaller local Cuban organization rather than an already established Lupertazzi FLA Crew loyal to Little Carmine, long time friend of Tony. This is what sells me on the idea that Carmine was operating independently without a traditional crew with in Miami.