Healthcare Provider Details

I. General information

NPI: 1528018694
Provider Name (Legal Business Name): RONALDO CARNEIRO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 COLLIER BLVD SUITE 303
NAPLES FL
34114
US

IV. Provider business mailing address

PO BOX 277575
ATLANTA GA
30384-7575
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-4040
  • Fax: 239-354-6440
Mailing address:
  • Phone: 239-348-4000
  • Fax: 239-354-6440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberFLME0049970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: