Healthcare Provider Details

I. General information

NPI: 1851512354
Provider Name (Legal Business Name): CARLOS BUZNEGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE 400-E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

8940 N KENDALL DR SUITE 400-E
MIAMI FL
33176-2148
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-2020
  • Fax: 305-274-0426
Mailing address:
  • Phone: 305-598-2020
  • Fax: 305-274-0426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME0058902
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: