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Individual

MRS. DIANA LYNN CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1030 NE 179TH ST, NORTH MIAMI BEACH, FL 33162-1216
(305) 921-9257
Mailing address
1030 NE 179TH ST, NORTH MIAMI BEACH, FL 33162-1216
(305) 921-9257

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2156
FL
225XP0200X
Pediatric Occupational Therapist
Primary
2156
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891184300
FL
Enumeration date
11/14/2007
Last updated
05/07/2008
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