Healthcare Provider Details

I. General information

NPI: 1568394856
Provider Name (Legal Business Name): CARSEN THORSELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W PALMETTO PARK RD APT 106
BOCA RATON FL
33432-3780
US

IV. Provider business mailing address

300 W PALMETTO PARK RD APT 106
BOCA RATON FL
33432-3780
US

V. Phone/Fax

Practice location:
  • Phone: 701-343-6472
  • Fax:
Mailing address:
  • Phone: 701-343-6472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: