MEDICARE: CARBON HEALTH MEDICAL GROUP OF FLORIDA 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1295316602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARBON HEALTH MEDICAL GROUP OF FLORIDA PA

Provider Business Mailing Address
First Line	:	2100 FRANKLIN ST STE 355
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-3140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4173 WORTH AVE # K105
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1533
Country	:	US
Telephone Number	:	844-234-7741
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MARLEY PAGE
Credential	:
Telephone Number	:	417-861-9739

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	06/25/2025

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