| Hector L Di Carlo Md Pa | |
|
500 Se 17th St Suite 110 Fort Lauderdale FL 33316-2547 | |
| (954) 533-1173 | |
| Not Available |
| Full Name | Hector L Di Carlo Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 500 Se 17th St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Hector Luis Di Carlo (PRESIDENT) |
| Authorized Official Contact | 9545331173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hector L Di Carlo Md Pa 500 Se 17th St Suite 110 Fort Lauderdale FL 33316-2547 Ph: (954) 533-1173 | Hector L Di Carlo Md Pa 500 Se 17th St Suite 110 Fort Lauderdale FL 33316-2547 Ph: (954) 533-1173 |
| NPI Number | 1598146474 |
|---|---|
| Provider Enumeration Date | 06/16/2015 |
| Last Update Date | 11/13/2015 |
| Medicare PECOS PAC ID | 8224347828 |
|---|---|
| Medicare Enrollment ID | O20151022000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598146474 | NPI | - | NPPES |
| 0011234400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | ME102570 (Florida) | Primary |
| Provider Name | Hector L Dicarlo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356597785 PECOS PAC ID: 3971662560 Enrollment ID: I20081112000041 |
| Provider Name | Gina N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770157687 PECOS PAC ID: 8729453956 Enrollment ID: I20230331000772 |
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