MEDICARE: CARLOS M MENESES

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	247200000X	Other Technician	MA44150	FL

General Provider Information

NPI Number	:	1255529616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS M MENESES

Provider Business Mailing Address
First Line	:	12008 SW 110TH STREET CIR S
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-3822
Country	:	US
Telephone Number	:	786-263-1734
Fax Number	:

Provider Business Practice Location Address
First Line	:	9290 SW 72ND ST
Second Line	:	SUITE 101
City	:	MIAMI
State	:	FL
Zip	:	33173-3236
Country	:	US
Telephone Number	:	305-273-9719
Fax Number	:	305-273-9796

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

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	10/11/2007

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Directions to “ CARLOS M MENESES ” Practice Location

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