Vivero, Carmen C

Vivero, Carmen C is an sole proprietor health care provider with primary practice located at 1301 Plantation Island Dr S Suite 402-B, St Augustine FL 32080-3108. She recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as her primary health care specialty. Vivero, Carmen C can be contacted via phone (904) 460-0707.

Contact Information

Primary practice address
1301 Plantation Island Dr S Suite 402-B St Augustine FL 32080-3108
Phone: (904) 460-0707
Fax: (904) 460-0727
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X ME0076599 Florida

Profile Details

NPI number 1316012743
LBN Legal business name Vivero, Carmen C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2006
Last updated Aug 19th, 2011 - about 15 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 1316012743 NPPES
Florida MEDICAID 281237100
Florida Other DN9360
Florida Other 44784

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