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General NPI Number Information
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NPI Number | 1528894284
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Entity Type | Organization
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Legal Business Name | DOCTOROFMEDICINE, LLC
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 14765 ENGLERT ALY
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City | ORLANDO
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State | FL
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Zip | 32827-7903
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Country | US
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Telephone | 786-247-6187
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Fax | 337-270-2662
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Provider Business Mailing Address
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Address Line | 14765 ENGLERT ALY
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City | ORLANDO
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State | FL
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Zip | 32827-7903
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Country | US
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Telephone | 786-247-6187
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Fax | 337-270-2662
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANUEL CARRAZANA
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Credential | MD, DABOM
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Telephone | 786-247-6187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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