MEDICARE: DR. CARLOS LUIS TRABANCO M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	49296	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013078278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS LUIS TRABANCO M.D

Provider Business Mailing Address
First Line	:	3735 SW 8TH ST STE 204
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-3161
Country	:	US
Telephone Number	:	305-445-2550
Fax Number	:	305-551-1710

Provider Business Practice Location Address
First Line	:	3735 SW 8TH ST STE 204
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-3161
Country	:	US
Telephone Number	:	305-445-2550
Fax Number	:	305-551-1710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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