Provider Demographics
NPI:1386612349
Name:VARGAS, CARLOS F (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:F
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:F
Other - Last Name:VARGAS-CANCINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2101 RIVERSIDE DR # 101
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6260
Mailing Address - Country:US
Mailing Address - Phone:954-341-6201
Mailing Address - Fax:954-341-6204
Practice Address - Street 1:2101 RIVERSIDE DR # 101
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6260
Practice Address - Country:US
Practice Address - Phone:954-341-6201
Practice Address - Fax:954-341-6204
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39935207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265214500Medicaid
E17831Medicare UPIN
FL265214500Medicaid
FL95812WMedicare ID - Type Unspecified