Individual
GRACE CARRASQUILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
909 JENSEN AVE, LAKELAND, FL 33815-0701
(863) 812-0987
Mailing address
909 JENSEN AVE, LAKELAND, FL 33815-0701
(863) 812-0987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9669770
FL
163WN0800X
Neuroscience Registered Nurse
RN9669770
FL
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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