Healthcare Provider Details

I. General information

NPI: 1063703825
Provider Name (Legal Business Name): ORLON V CARR III MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 JUPITER LAKES BLVD STE 5103
JUPITER FL
33458-7192
US

IV. Provider business mailing address

210 JUPITER LAKES BLVD STE 5103
JUPITER FL
33458-7192
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-7377
  • Fax: 561-743-7616
Mailing address:
  • Phone: 561-747-7377
  • Fax: 561-743-7616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME0037479
License Number StateFL

VIII. Authorized Official

Name: DR. ORLON VERE CARR III
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 561-747-7377