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General NPI Number Information
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NPI Number | 1780813865
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Entity Type | Individual
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Provider Name | CARLO PONTI D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 4823 NW 91ST WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-1908
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Country | US
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Telephone | 954-702-9672
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Fax | 954-702-9672
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Provider Business Mailing Address
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Address Line | 4823 NW 91ST WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-1908
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Country | US
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Telephone | 800-243-3839
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Fax | 954-839-2569
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 5101018432
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS12336
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DO1641
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License Number State | NV
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