MEDICARE: RAYMOND CARON PA

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	51784	FL

General Provider Information

NPI Number	:	1720430028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAYMOND CARON PA

Provider Business Mailing Address
First Line	:	453 N KIRKMAN RD
Second Line	:	SUITE 101
City	:	ORLANDO
State	:	FL
Zip	:	32811-1109
Country	:	US
Telephone Number	:	407-292-4453
Fax Number	:

Provider Business Practice Location Address
First Line	:	453 N KIRKMAN RD
Second Line	:	SUITE 101
City	:	ORLANDO
State	:	FL
Zip	:	32811-1109
Country	:	US
Telephone Number	:	407-292-4453
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAYMOND CARON
Credential	:	MD
Telephone Number	:	407-292-4453

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	07/11/2016

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