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General NPI Number Information
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NPI Number | 1437662939
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Entity Type | Individual
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Provider Name | NICOYAH CARLISLE
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Gender | Female
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 8950 SW 152ND ST STE 107
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2066
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Country | US
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Telephone | 786-281-3928
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Fax | 833-672-2767
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Provider Business Mailing Address
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Address Line | 13727 SW 152ND ST UNIT 638
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City | MIAMI
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State | FL
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Zip | 33177-1106
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Country | US
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Telephone |
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | OT21928
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 21928
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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