| Carlos A Vizcarra Md Pa | |
|
13837 Us Highway 1 Sebastian FL 32958-3232 | |
| (772) 589-9188 | |
| (772) 589-9187 |
| Full Name | Carlos A Vizcarra Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 13837 Us Highway 1, Sebastian, Florida |
| Authorized Official Name and Position | Carlos Andres Vizcarra (PRESIDENT) |
| Authorized Official Contact | 7725899188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlos A Vizcarra Md Pa 3897 Peacock Dr Melbourne FL 32904-9516 Ph: (321) 373-1160 | Carlos A Vizcarra Md Pa 13837 Us Highway 1 Sebastian FL 32958-3232 Ph: (772) 589-9188 |
| NPI Number | 1437248754 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0446252837 |
|---|---|
| Medicare Enrollment ID | O20070214000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437248754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME 931719 (Florida) | Primary |
| Provider Name | Carlos A Vizcarra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891729752 PECOS PAC ID: 4183656762 Enrollment ID: I20050902000556 |
| Provider Name | Penny S Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194149070 PECOS PAC ID: 3678866514 Enrollment ID: I20160729000647 |
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