Organization
CAROL DA COSTA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL ANA DA COSTA GOMEZ MD (PRESIDENT)
(305) 752-6465
Entity
Organization
Contact information
Practice address
15671 SW 88TH ST, MIAMI, FL 33196-1103
(305) 752-6465
(305) 752-6467
Mailing address
15671 SW 88TH ST, MIAMI, FL 33196-1103
(305) 752-6465
(305) 752-6467
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME73650
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269721100
—
FL
Enumeration date
11/02/2006
Last updated
05/12/2008
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