Provider Demographics
NPI:1710957907
Name:MAAS, CARLOS E (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4235 KINGS HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-8421
Mailing Address - Country:US
Mailing Address - Phone:941-613-1777
Mailing Address - Fax:941-613-1779
Practice Address - Street 1:4235 KINGS HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-8421
Practice Address - Country:US
Practice Address - Phone:941-613-1777
Practice Address - Fax:941-613-1779
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0061591207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371212500Medicaid
17914XMedicare ID - Type Unspecified
E65884Medicare UPIN