Provider Demographics
NPI:1669478087
Name:CARIFI, VINCENT G (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:G
Last Name:CARIFI
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:CARIFI BREAST CARE, P.A.
Mailing Address - Street 2:171 WEBB DRIVE - SUITE #1
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837
Mailing Address - Country:US
Mailing Address - Phone:863-421-7276
Mailing Address - Fax:863-421-7109
Practice Address - Street 1:CARIFI BREAST CARE, P.A.
Practice Address - Street 2:171 WEBB DRIVE - SUITE #1
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837
Practice Address - Country:US
Practice Address - Phone:863-421-7276
Practice Address - Fax:863-421-7109
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30206208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1669478087OtherNPI
FL53512OtherBLUE CROSS BLUE SHIELD
FL0586072-00Medicaid
FL53512YMedicare PIN
FL0586072-00Medicaid