Individual
CARLOS CARRASQUILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 SE WALTON LAKES DR, PORT SAINT LUCIE, FL 34952-3487
(772) 464-3303
Mailing address
403 SE WALTON LAKES DR, PORT SAINT LUCIE, FL 34952-3487
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA13082
FL
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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