MEDICARE: CARLOS SATULOVSKY MD PA

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	2084P0800X	Psychiatry Physician	ME93652	FL

General Provider Information

NPI Number	:	1174858518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS SATULOVSKY MD PA

Provider Business Mailing Address
First Line	:	3342 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6906
Country	:	US
Telephone Number	:	954-583-7267
Fax Number	:	954-583-0535

Provider Business Practice Location Address
First Line	:	3342 NE 34TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6906
Country	:	US
Telephone Number	:	954-583-7267
Fax Number	:	954-583-0535

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CARLOS SATULOVSKY
Credential	:	M.D.
Telephone Number	:	954-583-7267

Provider Enumeration Date	:	10/02/2009
Last Update Date	:	11/28/2011

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