Healthcare Provider Details

I. General information

NPI: 1598633083
Provider Name (Legal Business Name): CAROLYN HOLLINGSWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7775 BAYMEADOWS WAY
JACKSONVILLE FL
32256-7570
US

IV. Provider business mailing address

255 E RIVER RD
EAST PALATKA FL
32131-4192
US

V. Phone/Fax

Practice location:
  • Phone: 904-831-3974
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: