Provider Demographics
NPI:1790773281
Name:SATULOVSKY, CARLOS ABEL (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ABEL
Last Name:SATULOVSKY
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 1:3700 WASHINGTON ST STE 304
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8258
Mailing Address - Country:US
Mailing Address - Phone:954-961-1500
Mailing Address - Fax:954-961-7942
Practice Address - Street 1:3700 WASHINGTON ST STE 304
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8258
Practice Address - Country:US
Practice Address - Phone:954-961-1500
Practice Address - Fax:954-961-7942
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME936522084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273405200Medicaid
FLI39235Medicare UPIN
FLU5691ZMedicare ID - Type Unspecified