Provider Demographics
NPI:1093035438
Name:CARLOS CARRAZANA DC PA
Entity Type:Organization
Organization Name:CARLOS CARRAZANA DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRAZANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-562-0873
Mailing Address - Street 1:2261 N UNIVERSITY DR
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3623
Mailing Address - Country:US
Mailing Address - Phone:954-322-8981
Mailing Address - Fax:954-322-8985
Practice Address - Street 1:2261 N UNIVERSITY DR
Practice Address - Street 2:SUITE #101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3623
Practice Address - Country:US
Practice Address - Phone:954-966-6722
Practice Address - Fax:954-322-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty