Healthcare Provider Details

I. General information

NPI: 1518995398
Provider Name (Legal Business Name): CARLOS ROIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 NW 29TH ST
MIAMI FL
33127
US

IV. Provider business mailing address

161 NW 29TH ST
MIAMI FL
33127-3929
US

V. Phone/Fax

Practice location:
  • Phone: 305-576-0231
  • Fax:
Mailing address:
  • Phone: 305-576-0231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN306
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME 15936
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: