Individual
CARISSA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOME HEALTH
Contact information
Practice address
1638 HAWKSBILL ST NW, PALM BAY, FL 32907-7127
(321) 220-4512
Mailing address
1638 HAWKSBILL ST NW, PALM BAY, FL 32907-7127
(321) 220-4512
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Enumeration date
07/09/2020
Last updated
01/14/2021
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