Organization
CARROUSEL THERAPY CENTER CORPORATION
Active
Other names
CARROUSEL BEHAVIORAL HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE RIVERA (VICE PRESIDENT)
(407) 414-8409
Entity
Organization
Contact information
Practice address
3201 BUDINGER AVE, SAINT CLOUD, FL 34769-7203
(407) 891-3054
Mailing address
2520 SAND MINE RD, DAVENPORT, FL 33897-3402
(407) 891-3054
(800) 477-7678
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
882
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003711300
—
FL
Enumeration date
08/02/2016
Last updated
08/02/2016
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