Carcamo, Mario Ivan

Carcamo, Mario Ivan is an sole proprietor health care provider with primary practice located at 13852 Sw 88Th St , Miami FL 33186-1304. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Carcamo, Mario Ivan can be contacted via phone (305) 385-6885.

Contact Information

Primary practice address
13852 Sw 88Th St Miami FL 33186-1304
Phone: (305) 385-6885
Fax: (305) 380-7106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OPC002340 Florida
Eye and Vision Services Providers / Optometrist 152W00000X OPC002340 Florida

Profile Details

NPI number 1063594364
LBN Legal business name Carcamo, Mario Ivan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2006
Last updated Aug 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063594364 NPPES
Florida MEDICAID 78938100
Florida MEDICAID 101895300

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