1619242609 NPI number — MARILYN B. CARCAS P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619242609 NPI number — MARILYN B. CARCAS P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARILYN B. CARCAS P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619242609
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11588 SW 91ST TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33176-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-598-5337
Provider Business Mailing Address Fax Number:
305-595-0901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7100 SW 99TH AVE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33173-4667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-598-5337
Provider Business Practice Location Address Fax Number:
305-595-0901
Provider Enumeration Date:
03/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CARCAS
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
305-598-5337

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH2496 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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