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NPI Code Detail

MEDICARE: CARRILLO MEDICAL SERVICES INC

MEDICARE: CARRILLO MEDICAL SERVICES INC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1467785576
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARRILLO MEDICAL SERVICES INC
Provider Business Mailing Address
First Line : 2423 SW 147TH AVE
Second Line : STE 156
City : MIAMI
State : FL
Zip : 33185-4082
Country : US
Telephone Number : 305-926-7975
Fax Number :
Provider Business Practice Location Address
First Line : 2423 SW 147TH AVE
Second Line : STE 156
City : MIAMI
State : FL
Zip : 33185-4082
Country : US
Telephone Number : 305-926-7975
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. OMAR PADRON
Credential :
Telephone Number : 305-926-7975
Provider Enumeration Date : 09/09/2009
Last Update Date : 09/09/2009

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Directions to “CARRILLO MEDICAL SERVICES INC ” Practice Location

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