MEDICARE: SOFT CLOUD MUSIC THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist

General Provider Information

NPI Number	:	1205790391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOFT CLOUD MUSIC THERAPY, LLC

Provider Business Mailing Address
First Line	:	1540 INTERNATIONAL PKWY STE 2000
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5096
Country	:	US
Telephone Number	:	850-270-0620
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 INTERNATIONAL PKWY STE 2000
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5096
Country	:	US
Telephone Number	:	850-270-0620
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER OF PRACTICE
Name	:	ISABELLA CARVAJAL
Credential	:	MT-BC
Telephone Number	:	850-270-0620

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	06/15/2026

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