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General NPI Number Information
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NPI Number | 1154437028
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Entity Type | Individual
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Provider Name | CARLOS ERNESTO VACA MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 8260 W FLAGLER ST STE 2H
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City | MIAMI
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State | FL
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Zip | 33144-2069
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Country | US
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Telephone | 305-229-0551
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Fax | 305-229-1823
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Provider Business Mailing Address
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Address Line | 8260 W FLAGLER ST STE 2H
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City | MIAMI
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State | FL
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Zip | 33144-2069
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Country | US
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Telephone | 305-229-0551
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Fax | 305-229-1823
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME67188
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License Number State | FL
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