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General NPI Number Information
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NPI Number | 1073762043
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Entity Type | Individual
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Provider Name | ERIK CARRASCO M.D
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Gender | Male
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 15476 NW 77TH CT # 249
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5823
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Country | US
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Telephone | 917-680-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 8350 NW 157TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-6601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | ME 100206
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME100206
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License Number State | FL
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