Provider Demographics
NPI:1467499822
Name:VACLAVEK, CARIDAD LOZADA (MD)
Entity Type:Individual
Prefix:
First Name:CARIDAD
Middle Name:LOZADA
Last Name:VACLAVEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:LADAOZ
Other - Last Name:VACLAVEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8720 N KENDALL DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2299
Mailing Address - Country:US
Mailing Address - Phone:305-279-5253
Mailing Address - Fax:305-279-5810
Practice Address - Street 1:8720 N KENDALL DR
Practice Address - Street 2:SUITE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2299
Practice Address - Country:US
Practice Address - Phone:305-279-5253
Practice Address - Fax:305-279-5810
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17528174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist