Provider Demographics
NPI:1578660551
Name:JOHN G CAREY MD PA
Entity Type:Organization
Organization Name:JOHN G CAREY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-632-3500
Mailing Address - Street 1:7137 NORTH US HWY 1
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-5094
Mailing Address - Country:US
Mailing Address - Phone:321-632-3500
Mailing Address - Fax:321-690-2610
Practice Address - Street 1:7137 NORTH US HWY 1
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-5094
Practice Address - Country:US
Practice Address - Phone:321-632-3500
Practice Address - Fax:321-690-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2075118OtherAETNA
05514OtherBCBS
05514OtherBCBS
2075118OtherAETNA