Individual
DR. BRENT WILLIAM CARMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D P.A
Contact information
Practice address
900 CARILLON PKWY STE 111, ST PETERSBURG, FL 33716-1121
(727) 573-3937
(727) 573-4344
Mailing address
900 CARILLON PKWY, SUITE 111, ST PETERSBURG, FL 33716-1121
(727) 573-3937
(727) 573-4344
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME89731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270052200
—
FL
Enumeration date
09/26/2006
Last updated
02/25/2015
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