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General NPI Number Information
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NPI Number | 1689222663
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Entity Type | Individual
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Provider Name | CAROL KIM LE DO
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Gender | Female
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 3702 WASHINGTON ST STE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8283
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Country | US
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Telephone | 954-507-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 WASHINGTON ST STE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8283
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Country | US
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Telephone | 954-507-6636
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 17396
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 300511
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License Number State | NY
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