Provider Demographics
NPI:1386746519
Name:CARRO-ORTIZ, MARIA CARMEN (RPH)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CARMEN
Last Name:CARRO-ORTIZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 DAKOTA PL
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6502
Mailing Address - Country:US
Mailing Address - Phone:561-842-7050
Mailing Address - Fax:
Practice Address - Street 1:4113 DAKOTA PL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-6502
Practice Address - Country:US
Practice Address - Phone:561-842-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist