Organization
BRENT W CARMACK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEILA CARLEEN LAWRENCE CPOT (ADMINISTRATOR)
(727) 789-2020
Entity
Organization
Contact information
Practice address
900 CARILLON PKWY, STE 111, ST PETERSBURG, FL 33716-1121
(727) 573-3937
(727) 573-4344
Mailing address
900 CARILLON PKWY, STE 111, ST PETERSBURG, FL 33716-1121
(727) 573-3937
(727) 573-4344
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME89731
FL
Other
Enumeration date
11/08/2007
Last updated
12/12/2012
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