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General NPI Number Information
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NPI Number | 1598146474
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Entity Type | Organization
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Legal Business Name | HECTOR L DI CARLO MD PA
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 1321 S ANDREWS AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-1837
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Country | US
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Telephone | 954-533-1173
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Fax | 954-533-0723
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Provider Business Mailing Address
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Address Line | 1321 S ANDREWS AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-1837
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Country | US
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Telephone | 954-533-1173
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Fax | 964-533-0723
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HECTOR LUIS DI CARLO
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Credential | MD
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Telephone | 954-533-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME102570
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License Number State | FL
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