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General NPI Number Information
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NPI Number | 1013883941
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Entity Type | Individual
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Provider Name | QUIANA SHANDRISSE GENTLE CARMONA PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 7820 PETERS RD STE E100
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City | PLANTATION
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State | FL
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Zip | 33324-4019
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Country | US
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Telephone | 954-577-0095
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Fax | 954-423-0901
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Provider Business Mailing Address
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Address Line | 7820 PETERS RD STE E100
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City | PLANTATION
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State | FL
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Zip | 33324-4019
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Country | US
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Telephone | 954-577-0095
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Fax | 954-423-0901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY13008
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License Number State | FL
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