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General NPI Number Information
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NPI Number | 1508910365
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Entity Type | Organization
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Legal Business Name | EDWARD CARVALLO MD PA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5060 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-1927
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Country | US
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Telephone | 727-919-2395
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Fax | 352-596-2707
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Provider Business Mailing Address
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Address Line | 5060 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-1927
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Country | US
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Telephone | 727-919-2395
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Fax | 352-596-2707
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD CARVALLO
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Credential | MD
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Telephone | 727-919-2395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME31458
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License Number State | FL
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