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General NPI Number Information
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NPI Number | 1245937804
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Entity Type | Individual
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Provider Name | DR. VENISE PREDESTIN CARRIER
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 7600 S RED RD STE 200
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5403
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Country | US
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Telephone | 786-508-2207
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Fax |
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Provider Business Mailing Address
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Address Line | 218 N 26TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4841
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Country | US
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Telephone | 754-242-2609
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Fax |
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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 | PY11780
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License Number State | FL
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