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NPI Code Detail

MEDICARE: MISS TIARA CARROLL

MEDICARE: MISS TIARA 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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770258725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TIARA CARROLL
Provider Business Mailing Address
First Line : 1514 CLEARLAKE RD APT 142
Second Line :
City : COCOA
State : FL
Zip : 32922-6582
Country : US
Telephone Number : 813-328-9692
Fax Number :
Provider Business Practice Location Address
First Line : 2180 JULIAN AVE NE
Second Line :
City : PALM BAY
State : FL
Zip : 32905-4020
Country : US
Telephone Number : 321-345-0861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2021
Last Update Date : 04/19/2026

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Directions to “ MISS TIARA CARROLL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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