Healthcare Provider Details

I. General information

NPI: 1417179599
Provider Name (Legal Business Name): CRITICAL CARE CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 S MIAMI AVE
MIAMI FL
33133-4253
US

IV. Provider business mailing address

PO BOX 160417
MIAMI FL
33116-0417
US

V. Phone/Fax

Practice location:
  • Phone: 305-436-9933
  • Fax:
Mailing address:
  • Phone: 305-436-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS M MOAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-854-0616