Healthcare Provider Details

I. General information

NPI: 1003596164
Provider Name (Legal Business Name): SOFT CLOUD MUSIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 INTERNATIONAL PKWY STE 2000
LAKE MARY FL
32746-5096
US

IV. Provider business mailing address

1540 INTERNATIONAL PKWY STE 2000
LAKE MARY FL
32746-5096
US

V. Phone/Fax

Practice location:
  • Phone: 850-270-0620
  • Fax: 855-450-1801
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: ISABELLA CARVAJAL
Title or Position: CO-OWNER
Credential:
Phone: 239-250-0605