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NPI Code Detail

MEDICARE: RILEY LEWIS CARROLL

MEDICARE: RILEY LEWIS CARROLL
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
1170300000XGenetic Counselor (M.S.)157FL

General Provider Information

NPI Number : 1619452752
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY LEWIS CARROLL
Provider Business Mailing Address
First Line : 8649 A C SKINNER PKWY APT 727
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-7883
Country : US
Telephone Number : 561-676-2682
Fax Number :
Provider Business Practice Location Address
First Line : 841 PRUDENTIAL DR STE 1900
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8373
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2018
Last Update Date : 11/19/2025

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Directions to “ RILEY LEWIS CARROLL ” Practice Location

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