Carol Graham

Individual provider Active NPI Case Manager/Care Coordinator · Archer, FL

NPI 1629454657 · NPPES record last updated Aug 4, 2015

Key facts

NPI
1629454657
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
12450 NE 91St CT
Archer, FL 32618-6119
Phone
(954) 851-4941
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

12450 NE 91St CT
Archer, FL 32618-6119

Mailing address

12450 NE 91St Court
Archer, FL 32618
Phone (954) 851-4941

Other providers in Archer, FL

All providers in Archer, FL · Case Manager/Care Coordinator in Florida

Sources for this page

Verify at the official NPI Registry.