Provider Demographics
NPI:1619917374
Name:CARRERA, ROSEMARY ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:ANNE
Last Name:CARRERA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:ANNE
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:20 ALHAMBRA CIR APT 10
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4660
Mailing Address - Country:US
Mailing Address - Phone:305-498-6647
Mailing Address - Fax:305-265-5276
Practice Address - Street 1:8100 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1227
Practice Address - Country:US
Practice Address - Phone:305-265-7676
Practice Address - Fax:305-265-5276
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4027152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF627ZMedicare UPIN