Provider Demographics
NPI:1467895391
Name:VARGAS-LEON, CAROLA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLA
Middle Name:MARIA
Last Name:VARGAS-LEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 W 38TH PL
Mailing Address - Street 2:1207
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7077
Mailing Address - Country:US
Mailing Address - Phone:305-557-0211
Mailing Address - Fax:305-675-8249
Practice Address - Street 1:1711 W 38TH PL
Practice Address - Street 2:1207
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7077
Practice Address - Country:US
Practice Address - Phone:305-557-0211
Practice Address - Fax:305-675-8249
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29248207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME29248OtherMEDICAL LICENSE, DEPARTMENT OF HEALTH