Individual
DR. CARLOS MARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 HODGES BLVD STE 1, JACKSONVILLE, FL 32224-2207
(904) 347-2773
(904) 347-2773
Mailing address
PO BOX 17774, JACKSONVILLE, FL 32245-7774
(904) 347-2773
(904) 347-2773
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
057100
GA
208000000X
Pediatrics Physician
057100
GA
208000000X
Pediatrics Physician
Primary
ME 112541
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006488800
—
FL
Enumeration date
11/09/2006
Last updated
06/18/2013
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