Healthcare Provider Details
I. General information
NPI: 1639364144
Provider Name (Legal Business Name): CARLOS A. SESIN, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2007
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4302 ALTON RD SUITE 550
MIAMI BEACH FL
33140-2891
US
IV. Provider business mailing address
1801 PONCE DE LEON BLVD
CORAL GABLES FL
33134-4418
US
V. Phone/Fax
- Phone: 305-531-6766
- Fax: 305-531-6712
- Phone: 305-531-6766
- Fax: 305-531-6712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | ME89368 |
| License Number State | FL |
VIII. Authorized Official
Name:
CARLOS
ANTONIO
SESIN
Title or Position: DIRECTOR
Credential: MD
Phone: 305-531-6766