1407744485 NPI number — CARLOS AUGUSTO METIDIERI MENEOZZO

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 1407744485 NPI number — CARLOS AUGUSTO METIDIERI MENEOZZO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
METIDIERI MENEOZZO
Provider First Name:
CARLOS
Provider Middle Name:
AUGUSTO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1407744485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
582 FRANCA PINTO ST., VILA MARIANA, POSTAL CODE 04016-0
Provider Second Line Business Mailing Address:
APTO 111
Provider Business Mailing Address City Name:
SAO PAULO
Provider Business Mailing Address State Name:
SAO PAULO
Provider Business Mailing Address Postal Code:
04016
Provider Business Mailing Address Country Code:
BR
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 NW 12TH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-355-1122
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com