Provider Demographics
NPI:1114666450
Name:ADAMS, CAROLIN LATONYA
Entity Type:Individual
Prefix:MRS
First Name:CAROLIN
Middle Name:LATONYA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3273 UNIVERSITY BLVD N APT 254
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2412
Mailing Address - Country:US
Mailing Address - Phone:321-261-2366
Mailing Address - Fax:
Practice Address - Street 1:3273 UNIVERSITY BLVD N APT 254
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2412
Practice Address - Country:US
Practice Address - Phone:321-261-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL254774251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health