Organization
CARROUSEL THERAPY CENTER
Active
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
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003711300
—
FL
Enumeration date
08/27/2016
Last updated
08/27/2016
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