Athanasatos, Carly
Athanasatos, Carly is an sole proprietor health care provider with primary practice located at 10570 S Federal Hwy Swuite 200, Port St Lucie FL 34952-5606. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Athanasatos, Carly can be contacted via phone (772) 380-9972.Contact Information
Primary practice address
10570 S Federal Hwy Swuite 200
Port St Lucie FL 34952-5606
Phone: (772) 380-9972
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | Florida | |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X | Florida |
Profile Details
| NPI number | 1679979819 |
|---|---|
| LBN Legal business name | Athanasatos, Carly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 17th, 2014 |
| Last updated | Nov 17th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679979819 | NPPES |
| Florida | MEDICAID | PENDING |
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