Provider Demographics
NPI:1366862195
Name:ADAMS, CAROLYN E (RRT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463688 STATE ROAD 200
Mailing Address - Street 2:SUITE 1 #106
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-0304
Mailing Address - Country:US
Mailing Address - Phone:904-548-8283
Mailing Address - Fax:
Practice Address - Street 1:97268 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-7362
Practice Address - Country:US
Practice Address - Phone:904-382-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT12059227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered