Provider Demographics
NPI:1184705196
Name:COELHO, CARLOS E (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:COELHO
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 1:21097 N.E. 27 TH CT
Mailing Address - Street 2:SUITE 510
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1201
Mailing Address - Country:US
Mailing Address - Phone:305-932-6068
Mailing Address - Fax:305-932-6095
Practice Address - Street 1:21097 N.E. 27 TH CT
Practice Address - Street 2:SUITE 510
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1201
Practice Address - Country:US
Practice Address - Phone:305-932-6068
Practice Address - Fax:305-932-6095
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46870207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63994Medicare UPIN
FL96790BMedicare ID - Type Unspecified