Individual
DR. CARLOS AUGUSTO LIOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1404 E AVALON AVE, SUITE A, TUSCUMBIA, AL 35674-1773
(256) 381-5597
Mailing address
1404 E AVALON AVE, SUITE A, TUSCUMBIA, AL 35674-1773
(256) 381-5597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD.32516
AL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD.32516
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285874834
TRICARE
FL
Enumeration date
05/03/2007
Last updated
04/08/2016
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