Healthcare Provider Details

I. General information

NPI: 1942313291
Provider Name (Legal Business Name): MARC S CARP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NE MIAMI GARDENS DR SUITE 221
NORTH MIAMI BEACH FL
33179
US

IV. Provider business mailing address

PO BOX 848593
BOSTON MA
02284-8593
US

V. Phone/Fax

Practice location:
  • Phone: 305-949-2020
  • Fax: 305-949-6715
Mailing address:
  • Phone: 305-468-4180
  • Fax: 305-595-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0038332
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: