Healthcare Provider Details

I. General information

NPI: 1801242276
Provider Name (Legal Business Name): MARIA ALEJANDRA CARAVEDO MARTINEZ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ALEJANDRA CARAVEDO MD

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date: 12/30/2016
Reactivation Date: 04/28/2017

III. Provider practice location address

123 ANA DR
FLORENCE AL
35630-1731
US

IV. Provider business mailing address

PO BOX 650859 DEPT 710
DALLAS TX
75265-3806
US

V. Phone/Fax

Practice location:
  • Phone: 256-349-2533
  • Fax: 256-349-5946
Mailing address:
  • Phone: 409-772-2222
  • Fax: 305-585-8137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberT4719
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: