| Dr Efren Carbonell, MD | |
|
401 Cecil G Costin Sr Blvd, Port St Joe, FL 32456-1928 | |
| (850) 229-1043 | |
| (850) 229-1104 |
| Full Name | Dr Efren Carbonell |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 401 Cecil G Costin Sr Blvd, Port St Joe, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558307835 | NPI | - | NPPES |
| 1558307835 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 12359 (Puerto Rico) | Secondary |
| 208D00000X | General Practice | 12359 (Puerto Rico) | Secondary |
| 208D00000X | General Practice | ACN262 (Florida) | Primary |
| Entity Name | Pancare Of Florida, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366456287 PECOS PAC ID: 3476574229 Enrollment ID: O20150116000294 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Efren Carbonell, MD 403 E 11th St, Panama City, FL 32401-3409 Ph: (850) 747-5599 | Dr Efren Carbonell, MD 401 Cecil G Costin Sr Blvd, Port St Joe, FL 32456-1928 Ph: (850) 229-1043 |
Mrs. Carol A Sutton, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 220 9th St, Port St Joe, FL 32456 Phone: 850-229-8244 Fax: 850-229-6003 | |
Dr. Vincent M Ivers, General Practice Medicare: Accepting Medicare Assignments Practice Location: 301 20th St, Port St Joe, FL 32456 Phone: 850-227-7070 Fax: 850-227-1989 |