Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin William Carroll

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1861950255

Kevin William Carroll is a Student in an Organized Health Care Education/Training Program in Port Saint Lucie, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2019
Specialties on file
2

Practice location Address checks out

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone: (772) 345-8100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 405 W Grand Ave, Dayton, OH 45405-7538 — (937) 723-3245

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence OS18952 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1861950255
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 5, 2019
Last updated in NPPESJuly 8, 2022
Certification dateJuly 8, 2022
Mailing address10000 Sw Innovation Way, Port St Lucie, FL 34987-2111

Other providers in Port Saint Lucie