Individual
DR. EFREN CARBONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 CECIL G COSTIN SR BLVD, PORT ST JOE, FL 32456-1928
(850) 229-1043
(850) 229-1104
Mailing address
403 E 11TH ST, PANAMA CITY, FL 32401-3409
(850) 747-5599
(850) 872-4131
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
12359
PR
208D00000X
General Practice Physician
12359
PR
208D00000X
General Practice Physician
Primary
ACN262
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558307835
—
FL
Enumeration date
06/22/2006
Last updated
06/27/2024
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