MEDICARE: ALFREDO CARTAYA MD

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	207P00000X	Emergency Medicine Physician	ME20546	FL
2	207Q00000X	Family Medicine Physician	ME20546	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447218102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFREDO CARTAYA MD

Provider Business Mailing Address
First Line	:	4415 US HIGHWAY 331 S
Second Line	:
City	:	DEFUNIAK SPRINGS
State	:	FL
Zip	:	32435-6307
Country	:	US
Telephone Number	:	850-951-4556
Fax Number	:	850-951-4527

Provider Business Practice Location Address
First Line	:	4415 U.S. HWY 331 SOUTH
Second Line	:
City	:	DEFUNIAK SPRINGS
State	:	FL
Zip	:	32435-6307
Country	:	US
Telephone Number	:	850-951-4556
Fax Number	:	850-951-4527

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/20/2011

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Directions to “ ALFREDO CARTAYA MD” Practice Location

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