MEDICARE: DR. LUANA CARCASSONI 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	207Q00000X	Family Medicine Physician	47161	FL

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

General Provider Information

NPI Number	:	1972651164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUANA CARCASSONI M.D.

Provider Business Mailing Address
First Line	:	2899 COLLINS AVE
Second Line	:	APT 1626
City	:	MIAMI
State	:	FL
Zip	:	33140-4422
Country	:	US
Telephone Number	:	305-538-5239
Fax Number	:

Provider Business Practice Location Address
First Line	:	4578 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3325
Country	:	US
Telephone Number	:	305-538-5239
Fax Number	:

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

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	02/17/2016

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