Carcamo, Mario Ivan
Carcamo, Mario Ivan is an sole proprietor health care provider with primary practice located at 13852 Sw 88Th St , Miami FL 33186-1304. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Carcamo, Mario Ivan can be contacted via phone (305) 385-6885.Contact Information
Primary practice address
13852 Sw 88Th St
Miami FL 33186-1304
Phone: (305) 385-6885
Fax: (305) 380-7106
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OPC002340 | Florida |
Eye and Vision Services Providers / Optometrist | 152W00000X | OPC002340 | Florida |
Profile Details
NPI number | 1063594364 |
---|---|
LBN Legal business name | Carcamo, Mario Ivan |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 19th, 2006 |
Last updated | Aug 10th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063594364 | NPPES |
Florida | MEDICAID | 78938100 | |
Florida | MEDICAID | 101895300 |
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