MEDICARE: ADRIA EYVETTE CARPENTER

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	175T00000X	Peer Specialist		FL
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1356819965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIA EYVETTE CARPENTER

Provider Business Mailing Address
First Line	:	405 STRONG RD APT 144
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-5001
Country	:	US
Telephone Number	:	850-510-8773
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 STRONG RD APT 144
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-5001
Country	:	US
Telephone Number	:	850-510-8773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	04/15/2026

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Directions to “ ADRIA EYVETTE CARPENTER ” Practice Location

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