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Individual

CARISSA D AQUINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1747 BAPTIST CLAY DR STE 210, FLEMING ISLAND, FL 32003-8505
(904) 621-0396
(904) 621-0397
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT39040
FL
2255A2300X
Athletic Trainer
AL4644
FL

Other

Enumeration date
09/12/2018
Last updated
03/15/2023
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