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General NPI Number Information
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NPI Number | 1942796941
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Entity Type | Individual
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Provider Name | CARLOS ALBERTO HARTMANN CSA
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Gender | Male
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 1309 N FLAGLER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3406
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Country | US
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Telephone | 561-650-6097
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Fax | 561-650-6195
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Provider Business Mailing Address
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Address Line | 15210 SOUTHERN MARTIN ST
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4874
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Country | US
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Telephone | 407-274-7726
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Fax | 407-303-3825
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 18-321
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License Number State | FL
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