Basic Information
| Provider Information | |||||||||
| NPI: | 1063725877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARRAZANA | ||||||||
| FirstName: | ENRIQUE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1150 NW 14TH ST | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052439068 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1150 NW 14TH ST | ||||||||
| Address2: | 6TH FLOOR (M851) | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052439068 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2010 | ||||||||
| LastUpdateDate: | 07/21/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | ME56178 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.