Provider Demographics
NPI:1659738011
Name:MARKERSON, CAROLINE (MA)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MARKERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 N ORANGE AVE APT 2418
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1381
Mailing Address - Country:US
Mailing Address - Phone:561-315-7479
Mailing Address - Fax:
Practice Address - Street 1:668 N ORANGE AVE APT 2418
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1381
Practice Address - Country:US
Practice Address - Phone:561-315-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ7445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist