Provider Demographics
NPI:1306010590
Name:CARLOS A NOGUERA MD PA
Entity Type:Organization
Organization Name:CARLOS A NOGUERA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-271-1515
Mailing Address - Street 1:8740 SW 88TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2212
Mailing Address - Country:US
Mailing Address - Phone:305-271-1515
Mailing Address - Fax:
Practice Address - Street 1:8740 SW 88TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-271-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLOS A NOGUERA MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL97150207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty