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General NPI Number Information
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NPI Number | 1386861052
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Entity Type | Organization
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Legal Business Name | CARLOS M VERDEZA MD PA
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 13780 SW 26TH ST SUITE 203
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City | MIAMI
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State | FL
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Zip | 33175-6302
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Country | US
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Telephone | 305-553-8033
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Fax | 305-553-8013
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Provider Business Mailing Address
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Address Line | 13780 SW 26TH ST SUITE 203
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City | MIAMI
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State | FL
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Zip | 33175-6302
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Country | US
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Telephone | 305-553-8033
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Fax | 305-553-8013
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARLOS MARIO VERDEZA
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Credential | M.D
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Telephone | 305-553-8033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME97208
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License Number State | FL
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