Organization
ENT GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIO CARRENO (MANAGER)
(305) 450-1757
Entity
Organization
Contact information
Practice address
2400 SW 69TH AVE STE 140, MIAMI, FL 33155-2947
(305) 450-1757
(305) 265-4844
Mailing address
2400 SW 69TH AVE STE 140, MIAMI, FL 33155-2947
(305) 450-1757
(305) 265-4844
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
Other
Enumeration date
08/08/2021
Last updated
09/03/2021
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