Healthcare Provider Details

I. General information

NPI: 1457765174
Provider Name (Legal Business Name): JOHN JOSEPH CAREY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1800 NW 10TH AVE # M-820
MIAMI FL
33136-1018
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-1911
  • Fax: 305-545-6195
Mailing address:
  • Phone: 305-585-1191
  • Fax: 305-545-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA160603
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: