MEDICARE: CARLOS D TARIFA CSA

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	246ZS0410X	Surgical Technologist		FL

General Provider Information

NPI Number	:	1568619815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS D TARIFA CSA

Provider Business Mailing Address
First Line	:	3661 S. MIAMI AVE
Second Line	:	SUITE 708
City	:	MIAMI
State	:	FL
Zip	:	33133-4206
Country	:	US
Telephone Number	:	305-251-3991
Fax Number	:	305-251-7982

Provider Business Practice Location Address
First Line	:	3661 S. MIAMI AVE
Second Line	:	SUITE 708
City	:	MIAMI
State	:	FL
Zip	:	33133-4206
Country	:	US
Telephone Number	:	305-251-3991
Fax Number	:	305-251-7982

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

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	08/19/2008

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Directions to “ CARLOS D TARIFA CSA” Practice Location

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