MEDICARE: DR. ALICIA MARIA CARRAZANA DMD

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	1223G0001X	General Practice Dentistry	DN0012102	FL

General Provider Information

NPI Number	:	1124139837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA MARIA CARRAZANA DMD

Provider Business Mailing Address
First Line	:	214 ALMERIA AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5904
Country	:	US
Telephone Number	:	305-448-0603
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 ALMERIA AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5904
Country	:	US
Telephone Number	:	305-448-0603
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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