Healthcare Provider Details

I. General information

NPI: 1003036013
Provider Name (Legal Business Name): CARLOS A AZAR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE 705 E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

8940 N KENDALL DR SUITE 705 E
MIAMI FL
33176-2148
US

V. Phone/Fax

Practice location:
  • Phone: 305-835-7300
  • Fax: 305-696-3128
Mailing address:
  • Phone: 305-835-7300
  • Fax: 305-696-3128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberME44462
License Number StateFL

VIII. Authorized Official

Name: DR. CARLOS A AZAR
Title or Position: DIRECTOR
Credential: ME 44462
Phone: 305-835-7300