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General NPI Number Information
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NPI Number | 1063703825
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Entity Type | Organization
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Legal Business Name | ORLON V CARR III MD PA
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 210 JUPITER LAKES BLVD STE 5103
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City | JUPITER
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State | FL
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Zip | 33458-7192
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Country | US
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Telephone | 561-747-7377
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Fax | 561-743-7616
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Provider Business Mailing Address
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Address Line | 210 JUPITER LAKES BLVD STE 5103
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City | JUPITER
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State | FL
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Zip | 33458-7192
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Country | US
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Telephone | 561-747-7377
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Fax | 561-743-7616
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. ORLON VERE CARR III
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Credential | MD
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Telephone | 561-747-7377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME0037479
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License Number State | FL
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