Provider Demographics
NPI:1841352739
Name:CARRINGTON, SELWYN BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:SELWYN
Middle Name:BERNARD
Last Name:CARRINGTON
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 1:1613 N HIATUS RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2129
Mailing Address - Country:US
Mailing Address - Phone:954-432-9823
Mailing Address - Fax:954-432-8373
Practice Address - Street 1:1613 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-2129
Practice Address - Country:US
Practice Address - Phone:954-432-9823
Practice Address - Fax:954-432-8373
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49240174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102807OtherAVMED
FL17690OtherSTAYWELL
FL048023104Medicaid
FL17690OtherWELLCARE
FL05916OtherBLUE CROSS BLUE SHEILD
FL001692OtherNEIGHBORHOOD HEALTH PLAN
FL09688OtherHEALTHEASE
FLP00068416OtherRAILROAD MEDICARE
FL102807OtherAVMED
FLE11890Medicare UPIN