Organization
CARRERE GASTROENTEROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARRERE MD (OWNER)
(239) 278-1155
Entity
Organization
Contact information
Practice address
16848 FOX DEN, FORT MYERS, FL 33908-4322
(239) 278-1155
(239) 278-1159
Mailing address
16848 FOX DEN, FORT MYERS, FL 33908-4322
(239) 278-1155
(239) 278-1159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME85054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME85054
LICENSE NUMBER
FL
Enumeration date
10/16/2015
Last updated
10/16/2015
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