Provider Demographics
NPI:1033270251
Name:SPERA, CARLOS E (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:SPERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12575 ORANGE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4302
Mailing Address - Country:US
Mailing Address - Phone:954-577-8585
Mailing Address - Fax:954-577-8556
Practice Address - Street 1:12575 ORANGE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4302
Practice Address - Country:US
Practice Address - Phone:954-577-8585
Practice Address - Fax:954-577-8556
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME738112086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42585ZMedicare PIN
FLG79137Medicare UPIN