Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | ME82389 | FL |
Y | 2081P2900X | Pain Medicine | ME82389 | FL |
N | 2081S0010X | Sports Medicine | ME82389 | FL |
N | 213ES0000X | Sports Medicine | ME82389 | FL |
NPI | 1396751723 |
---|---|
Provider Name | Carlos Jose Placer Larrauri |
First Address | Orlando, FL 32835-3129 |
Second Address | Kissimmee, FL 34744-1615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 31/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03009 | BCBS (01) | |
111601 | AMERIGROUP (01) | |
261952100 | (05) | FL |
2940027 | AETNA (01) | FL |
331018616 | CIGNA (01) | |
331018616 | HUMANA (01) | |
331018616 | TRICARE (01) | |
331018616 | UHC (01) | |
5053308 | CIGNA (01) | FL |
H44611 | (02) |