Provider Demographics
NPI:1487618096
Name:CARO, PEDRO R (MD)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:R
Last Name:CARO
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 1:5850 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3363
Mailing Address - Country:US
Mailing Address - Phone:305-263-9590
Mailing Address - Fax:305-263-9657
Practice Address - Street 1:5850 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3363
Practice Address - Country:US
Practice Address - Phone:305-263-9590
Practice Address - Fax:305-263-9657
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066447174400000X
FLME66447207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25378OtherBLUE CROSS BLUE SHIELD #
FL375518500Medicaid
FLME0066447OtherMEDICAL LICENSE NUMBER
FL25378OtherBLUE CROSS BLUE SHIELD #
FLME0066447OtherMEDICAL LICENSE NUMBER
FLF83681Medicare UPIN