Provider Demographics
NPI:1528108461
Name:CARLOS SERRAO, M.D., P.A.
Entity type:Organization
Organization Name:CARLOS SERRAO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:SERRAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-823-4608
Mailing Address - Street 1:PO BOX 4525
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-0525
Mailing Address - Country:US
Mailing Address - Phone:305-823-4608
Mailing Address - Fax:305-825-9269
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-823-4608
Practice Address - Fax:305-825-9269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME17431207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91592Medicare ID - Type Unspecified
FLD77538Medicare UPIN