MEDICARE: DR. CARLOS A HANDAL-SACA M.D.

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	ME0072355	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160089	OTHER	FL	STAY WELL PROVIDER #
2	172504	OTHER	FL	JMH PLAN
3	0025955	OTHER	FL	NHP PROVIDER #
4	107395	OTHER	FL	HUMANA PROVIDER #
5	107396	OTHER	FL	HUMANA PROVIDER #
6	270390	OTHER	FL	AVMED PROVIDER NUMBER
7	592170298	OTHER	FL	UNITED HEALTHCARE PROVIDE
8	SG004535-F794	OTHER	FL	VISTA HEALTH PLAN PROVIDE
9	12-003353	OTHER	FL	UNITED HEALTHCARE PROVIDE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	592170298	OTHER	FL	TID
12	7303212	OTHER	FL	AETNA PROVIDER #
13	172497	OTHER	FL	JMH PLAN
14	213316	OTHER	FL	AMERIGROUP PROVIDER #
15	9441840001	OTHER	FL	CIGNA PAL ID
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	44267	OTHER	FL	BC/BS PROVIDER #
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891793337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS A HANDAL-SACA M.D.

Provider Business Mailing Address
First Line	:	4410 W 16TH AVE
Second Line	:	STE.# 60
City	:	HIALEAH
State	:	FL
Zip	:	33012-7194
Country	:	US
Telephone Number	:	305-823-0721
Fax Number	:	305-823-2041

Provider Business Practice Location Address
First Line	:	4410 W 16TH AVE
Second Line	:	STE.# 60
City	:	HIALEAH
State	:	FL
Zip	:	33012
Country	:	US
Telephone Number	:	305-823-0721
Fax Number	:	305-823-2041

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/09/2020

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