Healthcare Provider Details

I. General information

NPI: 1619917374
Provider Name (Legal Business Name): ROSEMARY ANNE CARRERA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSEMARY ANNE GONZALEZ OD

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 CORAL WAY
MIAMI FL
33155-1227
US

IV. Provider business mailing address

20 ALHAMBRA CIR APT 10
CORAL GABLES FL
33134-4660
US

V. Phone/Fax

Practice location:
  • Phone: 305-265-7676
  • Fax: 305-265-5276
Mailing address:
  • Phone: 305-498-6647
  • Fax: 305-265-5276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number4027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: