Individual
CAROLINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1461 NE 169TH ST APT 324, MIAMI, FL 33162-2869
(305) 777-8068
Mailing address
1461 NE 169TH ST APT 324, MIAMI, FL 33162-2869
(305) 777-8068
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001
—
FL
Enumeration date
08/12/2019
Last updated
08/21/2019
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