Provider Demographics
NPI:1609997907
Name:CARESS, DONALD L (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:CARESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17601 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169
Mailing Address - Country:US
Mailing Address - Phone:305-770-4500
Mailing Address - Fax:
Practice Address - Street 1:7800 NW 25TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1625
Practice Address - Country:US
Practice Address - Phone:305-593-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL176452083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBR885AMedicare PIN
FLBR885BMedicare PIN
FLBR885CMedicare PIN
FLCL047YMedicare UPIN
FLCL047XMedicare UPIN
FLCL047ZMedicare UPIN