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General NPI Number Information
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NPI Number | 1881866796
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Entity Type | Individual
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Provider Name | LUIS MARCELO CARCACHE MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 4175 W 20TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-5874
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Country | US
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Telephone | 305-424-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 SW 192ND AVE
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City | MIRAMAR
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State | FL
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Zip | 33029-5822
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Country | US
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Telephone | 305-310-4312
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME110603
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME110603
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License Number State | FL
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