Provider Demographics
NPI:1881427763
Name:ELWORTHY, CAROLINE ROSE
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ROSE
Last Name:ELWORTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 WINTER GARDEN VINELAND RD STE 112
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4449
Mailing Address - Country:US
Mailing Address - Phone:407-877-0029
Mailing Address - Fax:
Practice Address - Street 1:1222 WINTER GARDEN VINELAND RD STE 112
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4449
Practice Address - Country:US
Practice Address - Phone:407-877-0029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL53942355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant