Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME88760 | FL |
NPI | 1376652131 |
---|---|
Provider Name | Dr. Mauri Carakushansky |
First Address | Rockland, DE 19732-0191 |
Second Address | Orlando, FL 32806-1046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 07/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268367900 | (05) | FL |
I12752 | (02) |