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Individual

DR. MARIO IVAN CARCAMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
13852 SW 88TH ST, MIAMI, FL 33186-1304
(305) 385-6885
(305) 380-7106
Mailing address
13852 SW 88TH ST, MIAMI, FL 33186-1304
(305) 385-6885
(888) 371-2283

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC002340
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC002340
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101895300
FL
05
78938100
FL
Enumeration date
10/19/2006
Last updated
08/10/2023
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