=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750787701
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARLOS A SABATES MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2014
-----------------------------------------------------
Last Update Date | 11/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 747 PONCE DE LEON BLVD SUITE 602
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-443-9342
-----------------------------------------------------
Fax | 305-443-4849
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 747 PONCE DE LEON BLVD SUITE 602
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-443-9342
-----------------------------------------------------
Fax | 305-443-4849
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CARLOS A SABATES
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 305-443-9342
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME43507
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------