Provider Demographics
NPI:1740431014
Name:CARMEN R DAMIANI DO PA
Entity Type:Organization
Organization Name:CARMEN R DAMIANI DO PA
Other - Org Name:CENTER FOR WOMEN & FAMILY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:DAMIANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-397-8888
Mailing Address - Street 1:10011 SEMINOLE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2539
Mailing Address - Country:US
Mailing Address - Phone:727-397-8888
Mailing Address - Fax:727-399-9828
Practice Address - Street 1:10011 SEMINOLE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-2539
Practice Address - Country:US
Practice Address - Phone:727-397-8888
Practice Address - Fax:727-399-9828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARMEN R DAMIANI DO PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4399207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047757500Medicaid
FL82455Medicare PIN
FLA16838Medicare UPIN