MEDICARE: RILEY LEWIS CARROLL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	157	FL

General Provider Information

NPI Number	:	1619452752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY LEWIS CARROLL

Provider Business Mailing Address
First Line	:	8649 A C SKINNER PKWY APT 727
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7883
Country	:	US
Telephone Number	:	561-676-2682
Fax Number	:

Provider Business Practice Location Address
First Line	:	1622 LOCUST ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5924
Country	:	US
Telephone Number	:	412-642-1940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	05/07/2026

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Directions to “ RILEY LEWIS CARROLL ” Practice Location

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