Provider Demographics
NPI:1659313385
Name:RABASSA, CARLA C (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:C
Last Name:RABASSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7100 PINES BLVD
Mailing Address - Street 2:SUITE 23
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7355
Mailing Address - Country:US
Mailing Address - Phone:954-967-0107
Mailing Address - Fax:954-967-0109
Practice Address - Street 1:885 SW 109 AVE
Practice Address - Street 2:ROOM 131
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-0001
Practice Address - Country:US
Practice Address - Phone:305-348-0254
Practice Address - Fax:305-348-4261
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2015-08-20
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Provider Licenses
StateLicense IDTaxonomies
FLME 85185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265269200Medicaid
FL014389500Medicaid
FL265269200Medicaid
FL014389500Medicaid