Provider Demographics
NPI:1013883941
Name:GENTLE CARMONA, QUIANA SHANDRISSE (PSYD)
Entity type:Individual
Prefix:MS
First Name:QUIANA
Middle Name:SHANDRISSE
Last Name:GENTLE CARMONA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 PETERS RD STE E100
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4019
Mailing Address - Country:US
Mailing Address - Phone:954-577-0095
Mailing Address - Fax:954-423-0901
Practice Address - Street 1:7820 PETERS RD STE E100
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4019
Practice Address - Country:US
Practice Address - Phone:954-577-0095
Practice Address - Fax:954-423-0901
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY13008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical