Healthcare Provider Details

I. General information

NPI: 1912836057
Provider Name (Legal Business Name): JOHN HENRY CARTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3031 MOSS VALLEY PL
WINTER PARK FL
32792-8117
US

IV. Provider business mailing address

3031 MOSS VALLEY PL
WINTER PARK FL
32792-8117
US

V. Phone/Fax

Practice location:
  • Phone: 407-625-2992
  • Fax:
Mailing address:
  • Phone: 407-625-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA30627
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: