Healthcare Provider Details

I. General information

NPI: 1376460618
Provider Name (Legal Business Name): MS. ADRIANA CARRION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 GULF TO BAY BLVD APT 1310
CLEARWATER FL
33759-4020
US

IV. Provider business mailing address

2855 GULF TO BAY BLVD APT 1310
CLEARWATER FL
33759-4020
US

V. Phone/Fax

Practice location:
  • Phone: 813-428-2794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: