Provider Demographics
NPI:1750345757
Name:VARGAS, CARLOS ARMANDO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ARMANDO
Last Name:VARGAS
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 1:11440 N KENDALL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1044
Mailing Address - Country:US
Mailing Address - Phone:305-596-1844
Mailing Address - Fax:305-596-6810
Practice Address - Street 1:11440 N KENDALL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1044
Practice Address - Country:US
Practice Address - Phone:305-596-1844
Practice Address - Fax:305-596-6810
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53296174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371210900Medicaid
FL371210900Medicaid
FL18048Medicare PIN