MEDICARE: RAUL A CARRIL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9100714	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265481964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL A CARRIL PA

Provider Business Mailing Address
First Line	:	5948 TURKEY LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4202
Country	:	US
Telephone Number	:	407-288-8080
Fax Number	:	407-352-0104

Provider Business Practice Location Address
First Line	:	5948 TURKEY LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4202
Country	:	US
Telephone Number	:	407-288-8080
Fax Number	:	407-352-0104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	06/07/2016

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Directions to “ RAUL A CARRIL PA” Practice Location

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