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NPI Code Detail

MEDICARE: CAROL WALTON, PSY.D., P.A.

MEDICARE: CAROL WALTON, PSY.D., P.A.
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
1103TC0700XClinical PsychologistPY0004344FL

General Provider Information

NPI Number : 1366627051
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROL WALTON, PSY.D., P.A.
Provider Business Mailing Address
First Line : 2902 BAY BLVD NE
Second Line :
City : PALM BAY
State : FL
Zip : 32905-3604
Country : US
Telephone Number : 321-725-9607
Fax Number : 321-728-8506
Provider Business Practice Location Address
First Line : 1900 S HARBOR CITY BLVD
Second Line : SUITE 203
City : MELBOURNE
State : FL
Zip : 32901-4749
Country : US
Telephone Number : 321-725-9607
Fax Number : 321-728-8506
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. CAROLWALTON WALTON
Credential : PSY.D.
Telephone Number : 321-725-9607
Provider Enumeration Date : 01/01/2008
Last Update Date : 01/01/2008

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