Provider Demographics
NPI:1659692911
Name:CARRASQUILLO, CAROLINA (MSW, ACSW)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5447 VINELAND RD
Mailing Address - Street 2:APT. 1309
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5447 VINELAND RD
Practice Address - Street 2:APT. 1309
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7600
Practice Address - Country:US
Practice Address - Phone:787-367-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical