Individual
CARLOS MARIO OLIVEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR STE 1D, MELBOURNE, FL 32901
(321) 312-3480
(321) 722-1237
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
ME36302
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05434
BCBS OF FLORIDA
FL
01
—
05434Y
FL MEDICARE
FL
05
—
065583000
—
FL
01
—
160034381
RR MEDICARE
FL
01
—
P01164169
RR MEDICARE
FL
Enumeration date
12/01/2005
Last updated
02/28/2020
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