Provider Demographics
NPI:1164576526
Name:SELEME, CARLA (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:SELEME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 KENNEDY DR
Mailing Address - Street 2:SUITE 1028
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4023
Mailing Address - Country:US
Mailing Address - Phone:305-295-2840
Mailing Address - Fax:305-295-2845
Practice Address - Street 1:1200 KENNEDY DR
Practice Address - Street 2:SUITE 1028
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4023
Practice Address - Country:US
Practice Address - Phone:305-295-2840
Practice Address - Fax:305-295-2845
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME90947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI21910Medicare UPIN
FLU3859AMedicare PIN