Healthcare Provider Details

I. General information

NPI: 1851078828
Provider Name (Legal Business Name): CARBON HEALTH MEDICAL GROUP OF FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 THE FENWAY STE 210-224
BOSTON MA
02115-5725
US

IV. Provider business mailing address

2100 FRANKLIN ST STE 355
OAKLAND CA
94612-3140
US

V. Phone/Fax

Practice location:
  • Phone: 617-865-2749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLEY PAGE
Title or Position: DIRECTOR
Credential:
Phone: 417-861-9739