Provider Demographics
NPI:1851512354
Name:BUZNEGO, CARLOS (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:BUZNEGO
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 1:8940 N KENDALL DR
Mailing Address - Street 2:SUITE 400-E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2148
Mailing Address - Country:US
Mailing Address - Phone:305-598-2020
Mailing Address - Fax:305-274-0426
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:SUITE 400-E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-598-2020
Practice Address - Fax:305-274-0426
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058902207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053574500Medicaid
FL053574500Medicaid
FLE86675Medicare UPIN