Provider Demographics
NPI:1043655020
Name:IVAN CARRERAS MD PA
Entity Type:Organization
Organization Name:IVAN CARRERAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-884-8891
Mailing Address - Street 1:45 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3023
Mailing Address - Country:US
Mailing Address - Phone:305-884-8891
Mailing Address - Fax:888-242-3852
Practice Address - Street 1:45 W 17TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3023
Practice Address - Country:US
Practice Address - Phone:305-884-8891
Practice Address - Fax:888-242-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty