MEDICARE: DR. ADAM NICHOLAS CARSON D.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	1223G0001X	General Practice Dentistry	DN17845	FL

General Provider Information

NPI Number	:	1255508339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM NICHOLAS CARSON D.M.D.

Provider Business Mailing Address
First Line	:	100 LINCOLN RD # CU7
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2013
Country	:	US
Telephone Number	:	305-532-6977
Fax Number	:	305-532-0050

Provider Business Practice Location Address
First Line	:	100 LINCOLN RD # CU7
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2013
Country	:	US
Telephone Number	:	305-532-6977
Fax Number	:	305-532-0050

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

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	07/08/2009

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