Provider Demographics
NPI:1427001502
Name:ROS CARRETERO, JUAN PIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:PIO
Last Name:ROS CARRETERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5483 W WATERS AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1236
Mailing Address - Country:US
Mailing Address - Phone:813-287-5718
Mailing Address - Fax:813-287-5728
Practice Address - Street 1:2820 BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-4760
Practice Address - Country:US
Practice Address - Phone:863-414-8131
Practice Address - Fax:813-287-5728
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68749207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260808100Medicaid
FLH33143Medicare UPIN