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Individual

OCTAVIO DE JESUS CARRENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3100 SW 62ND AVE, STE 124, MIAMI, FL 33155
(305) 662-8316
(305) 663-8513
Mailing address
3100 SW 62ND AVE., STE 124, MIAMI, FL 33155
(305) 662-8316
(305) 663-8513

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
ME78105
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432628999
ME
Enumeration date
03/31/2006
Last updated
09/14/2021
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