Provider Demographics
NPI:1548980428
Name:CARTER, ARTIST C
Entity type:Individual
Prefix:
First Name:ARTIST
Middle Name:C
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 NW 160TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6840
Mailing Address - Country:US
Mailing Address - Phone:786-547-9996
Mailing Address - Fax:
Practice Address - Street 1:POSITIVE BEHAVIOR TREATMENT
Practice Address - Street 2:1400 NE MIAMI GARDENS DR. SUITE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:786-274-7777
Practice Address - Fax:305-436-3712
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT19104083106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician