Provider Demographics
NPI:1225237043
Name:CARISMA, ESAIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ESAIE
Middle Name:
Last Name:CARISMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 JOHNSON ST
Mailing Address - Street 2:MEMORIAL REGIONAL HOSPITAL
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5421
Mailing Address - Country:US
Mailing Address - Phone:954-265-9976
Mailing Address - Fax:954-965-6396
Practice Address - Street 1:3501 JOHNSON ST
Practice Address - Street 2:MEMORIAL REGIONAL HOSPITAL
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:954-265-9976
Practice Address - Fax:954-965-6396
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08219100207R00000X
FLOS10698207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ91002597600OtherAMERICHOICE
NJ0150886Medicaid
NJ121849TM8Medicare PIN