Healthcare Provider Details

I. General information

NPI: 1669478087
Provider Name (Legal Business Name): VINCENT G CARIFI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARIFI BREAST CARE, P.A. 171 WEBB DRIVE - SUITE #1
DAVENPORT FL
33837
US

IV. Provider business mailing address

CARIFI BREAST CARE, P.A. 171 WEBB DRIVE - SUITE #1
DAVENPORT FL
33837
US

V. Phone/Fax

Practice location:
  • Phone: 863-421-7276
  • Fax: 863-421-7109
Mailing address:
  • Phone: 863-421-7276
  • Fax: 863-421-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME30206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: