Organization
JUAN J CARRERE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN J CARRERE MD (MANAGING MEMBER)
(814) 913-1440
Entity
Organization
Contact information
Practice address
13710 METROPOLIS AVE, SUITE 110, FORT MYERS, FL 33912-7144
(239) 415-2273
(239) 415-2280
Mailing address
1633 TREASURE LK, DU BOIS, PA 15801-9043
(814) 913-1440
(814) 913-1440
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME85054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AQ777
MEDICARE PTAN
FL
01
—
DO8380
RAILROAD MEDICARE
FL
Enumeration date
09/30/2008
Last updated
10/07/2009
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