# MARIO CARCAMO PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARIO CARCAMO O.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386875896
- **Authorized official:** DR. MARIO IVAN CARCAMO O.D. (MANAGER OWNER)
- **Authorized official phone:** (305) 662-2990

## Contact information

- **Practice address:** 7795 W FLAGLER ST, \#63, MIAMI, FL 33144-2368
- **Practice address phone:** (305) 662-2990
- **Practice address fax:** (305) 380-7106
- **Mailing address:** 7795 W FLAGLER ST, \#63, MIAMI, FL 33144-2359
- **Mailing address phone:** (305) 662-2990
- **Mailing address fax:** (305) 380-7106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2009
- **Last updated:** 09/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078938100 | — | FL |