Provider Demographics
NPI:1780816504
Name:CARRANZA, CARLOS D (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:D
Last Name:CARRANZA
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:PO BOX 440724
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-0724
Mailing Address - Country:US
Mailing Address - Phone:786-553-4643
Mailing Address - Fax:
Practice Address - Street 1:2500SW107TH AVE 46-47
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2470
Practice Address - Country:US
Practice Address - Phone:305-485-1532
Practice Address - Fax:305-485-1534
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 23298207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMEDICARE UPIN:D65970Medicare UPIN