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General NPI Number Information
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NPI Number | 1508587122
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Entity Type | Individual
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Provider Name | AGOSTINA CARRION
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 21097 NE 27TH CT STE 540
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City | AVENTURA
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State | FL
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Zip | 33180-1235
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Country | US
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Telephone | 305-914-3480
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Fax |
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Provider Business Mailing Address
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Address Line | 3921 SW 160TH AVE APT 202
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City | MIRAMAR
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State | FL
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Zip | 33027-4673
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Country | US
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Telephone | 786-273-6383
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9116367
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License Number State | FL
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