MEDICARE: MRS. CARLA JACKSON HAWKINS

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	373H00000X	Day Training/Habilitation Specialist		FL

General Provider Information

NPI Number	:	1558214403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARLA JACKSON HAWKINS

Provider Business Mailing Address
First Line	:	7642 LAKE ANGELINA DR
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-7154
Country	:	US
Telephone Number	:	407-234-7244
Fax Number	:	407-234-7244

Provider Business Practice Location Address
First Line	:	5425 TERRELL RD
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-7405
Country	:	US
Telephone Number	:	407-234-7244
Fax Number	:

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

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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