Provider Demographics
NPI:1215346499
Name:CARLOS HURTADO MD PA
Entity type:Organization
Organization Name:CARLOS HURTADO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:HURTADO INFANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-262-1393
Mailing Address - Street 1:PO BOX 126927
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-1615
Mailing Address - Country:US
Mailing Address - Phone:786-262-1393
Mailing Address - Fax:
Practice Address - Street 1:383 W 34TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4309
Practice Address - Country:US
Practice Address - Phone:786-262-1393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1148972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty