Provider Demographics
NPI:1205817434
Name:SARENAS, CAROLINA C (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:C
Last Name:SARENAS
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 1:1295 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2732
Mailing Address - Country:US
Mailing Address - Phone:321-637-6654
Mailing Address - Fax:321-433-1119
Practice Address - Street 1:1295 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2732
Practice Address - Country:US
Practice Address - Phone:321-637-6654
Practice Address - Fax:321-433-1119
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67269207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376832500Medicaid
FLF94394Medicare UPIN