Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME 108416 | FL |
NPI | 1023314952 |
---|---|
Provider Name | Carlos Rafael Zamora |
First Address | Jacksonville, FL 32203-3667 |
Second Address | Fleming Island, FL 32003-8502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2011 |
Last Update Date | 08/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006703700 | (05) | FL |
P01723356 | RR MEDICARE (01) | FL |