MEDICARE: THRIVE MIAMI, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103K00000X	Behavior Analyst
3	208100000X	Physical Medicine & Rehabilitation Physician
4	225100000X	Physical Therapist
5	225X00000X	Occupational Therapist
6	225XP0019X	Physical Rehabilitation Occupational Therapist
7	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1841154424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE MIAMI, LLC

Provider Business Mailing Address
First Line	:	17020 SW 92ND CT
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-4543
Country	:	US
Telephone Number	:	305-815-6028
Fax Number	:

Provider Business Practice Location Address
First Line	:	17020 SW 92ND CT
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-4543
Country	:	US
Telephone Number	:	305-815-6028
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER CARLO
Credential	:	LMHC
Telephone Number	:	305-815-6028

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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