MEDICARE: CARLOS A BRUNO 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	208000000X	Pediatrics Physician	022562	LA

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	1538153135	OTHER	LA	NPI

General Provider Information

NPI Number	:	1538153135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS A BRUNO MD

Provider Business Mailing Address
First Line	:	811 ALBERTSONS PARKWAY
Second Line	:	SUITE A
City	:	BROUSSARD
State	:	LA
Zip	:	70518
Country	:	US
Telephone Number	:	337-839-2265
Fax Number	:	337-839-2213

Provider Business Practice Location Address
First Line	:	811 ALBERTSON PKWY
Second Line	:	SUITE A
City	:	BROUSSARD
State	:	LA
Zip	:	70518-5256
Country	:	US
Telephone Number	:	337-839-2265
Fax Number	:	337-839-2213

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	02/13/2015

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Directions to “ CARLOS A BRUNO MD” Practice Location

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