Provider Demographics
NPI:1962581017
Name:NOGUERA, CARLOS ARTURO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ARTURO
Last Name:NOGUERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:A
Other - Last Name:NOGUERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PA
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:78 SW 13TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2479
Practice Address - Country:US
Practice Address - Phone:305-642-6966
Practice Address - Fax:305-642-6965
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97150207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14428OtherDIMENSION
FL1260034OtherWELLCARE
FL317874OtherAVMED
FL14F1WOtherBCBS
FLP01631679OtherRR MEDICARE
FLP01631679OtherRR MEDICARE