Provider Demographics
NPI:1063739365
Name:CARVAJAL, ARTURO E (MD)
Entity type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:E
Last Name:CARVAJAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85058
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33008
Mailing Address - Country:US
Mailing Address - Phone:954-456-6122
Mailing Address - Fax:954-456-6122
Practice Address - Street 1:3990 W FLAGLER ST STE 403
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1644
Practice Address - Country:US
Practice Address - Phone:305-444-4100
Practice Address - Fax:305-444-4143
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28403208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056629200Medicaid
FL056629200Medicaid
FLD79907Medicare PIN