Healthcare Provider Details

I. General information

NPI: 1487618096
Provider Name (Legal Business Name): PEDRO R CARO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 W FLAGLER ST
MIAMI FL
33144-3363
US

IV. Provider business mailing address

5850 W FLAGLER ST
MIAMI FL
33144-3363
US

V. Phone/Fax

Practice location:
  • Phone: 305-263-9590
  • Fax: 305-263-9657
Mailing address:
  • Phone: 305-263-9590
  • Fax: 305-263-9657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0066447
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME66447
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME66447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: