Provider Demographics
NPI:1194851428
Name:CARLONE, DEBORAH SUSAN (MD)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SUSAN
Last Name:CARLONE
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 1:3505 S OCEAN DR
Mailing Address - Street 2:#721
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2831
Mailing Address - Country:US
Mailing Address - Phone:954-924-8116
Mailing Address - Fax:
Practice Address - Street 1:971 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1205
Practice Address - Country:US
Practice Address - Phone:786-446-2300
Practice Address - Fax:305-325-3489
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257989800Medicaid
FLH09660Medicare UPIN
FL32960YMedicare ID - Type Unspecified