Provider Demographics
NPI:1235759978
Name:DUGARTE FLORES, CARLOS J (ADN)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:J
Last Name:DUGARTE FLORES
Suffix:
Gender:M
Credentials:ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10073 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3002
Mailing Address - Country:US
Mailing Address - Phone:813-232-1234
Mailing Address - Fax:
Practice Address - Street 1:10073 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3002
Practice Address - Country:US
Practice Address - Phone:813-232-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program