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NPI Code Detail

MEDICARE: MARCOS JOSE CARVAJAL APRN

MEDICARE:   MARCOS JOSE CARVAJAL  APRN
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
1363LF0000XFamily Nurse PractitionerAPRN11006467FL

General Provider Information

NPI Number : 1649537606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCOS JOSE CARVAJAL APRN
Provider Business Mailing Address
First Line : 2401 DUNHILL AVE
Second Line :
City : MIRAMAR
State : FL
Zip : 33025-3813
Country : US
Telephone Number : 786-447-2035
Fax Number :
Provider Business Practice Location Address
First Line : 2401 DUNHILL AVE
Second Line :
City : MIRAMAR
State : FL
Zip : 33025-3813
Country : US
Telephone Number : 786-447-2035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 12/11/2020

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Directions to “ MARCOS JOSE CARVAJAL APRN” Practice Location

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