DR. EDDY HERBERT CARRILLO (NPI# 1548207681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548207681 |
| Entity Type | Individual |
| Full Name | DR. EDDY HERBERT CARRILLO |
| Credential | MD |
| Practice Address |
1150 N 35th Avenue Suite 135 Hollywood FL 33021 |
| Practice Telephone | 9542655969 |
| Practice Fax Number | 9549653599 |
| Mailing Telephone | 9542655969 |
| Mailing Fax Number | 9549653599 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2011-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
ME60243 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 262208400 | 05 | |
| FL | GROUP NPI | 1659389161 | 01 |
| FL | 26220800 | 05 |
| Street Address |
1150 N 35TH AVENUE SUITE 135 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679523393 | Patricia Joza | Physician Assistant | 1150 N 35th Avenue, Suite 445 Mark Lamet Md Pa, Hollywood, FL 33021 | 2006-05-11 |
| 1437600848 | Melissa Haydee Diaz | Nurse Practitioner | 1150 N 35th Avenue, Suite 100, Hollywood, FL 33021 | 2016-10-20 |
| 1639629694 | Jada Santos | Psychologist | 1150 N 35th Avenue, Ste 590, Hollywood, FL 33021 | 2016-10-13 |
| 1396292702 | Krystina Serpa | Registered Nurse | 1150 N 35th Avenue, Ste 660, Hollywood, FL 33021 | 2016-09-01 |
| 1578924163 | Miriam Yonina Ross | Nurse Practitioner | 1150 N 35th Avenue, Suite 590, Hollywood, FL 33021 | 2016-03-10 |
| 1225420441 | Shari Selesky | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2015-02-25 |
| 1013308741 | Austin Horner | Physician Assistant | 1150 N 35th Avenue, Ste 600, Hollywood, FL 33021 | 2015-02-17 |
| 1043635899 | Riya Jacob | Nurse Practitioner | 1150 N 35th Avenue, Suite 605, Hollywood, FL 33021 | 2014-03-03 |
| 1366785743 | South Broward Hospital District | Surgery | 1150 N 35th Avenue, Ste 460, Hollywood, FL 33021 | 2013-04-03 |
| 1831418458 | Armaal Rashard Hunter | Physician Assistant | 1150 N 35th Avenue, Suite 440, Hollywood, FL 33021-5430 | 2010-05-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861771610 | Dafney L Davare | Surgery | 3501 Johnson St, Division of Trauma and Emergency Surgery, Hollywood, FL 33021-5421 | 2011-08-11 |
| 1952630899 | Chauniqua Dawn Kiffin | Surgery | 1150 N 35th Ave, Suite 135, Hollywood, FL 33021-5424 | 2009-12-23 |
| 1356351076 | Andrew Rosenthal | Surgery | 1150 N 35th Ave, Suite 135, Hollywood, FL 33021-5424 | 2006-08-08 |
| 1710996749 | Rafael Sanchez | Surgery | 1150 N 35th Ave, Suite 135, Hollywood, FL 33021-5424 | 2006-08-07 |
| 1659389161 | South Broward Hospital District | Surgery | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-08-03 |
| 1922021120 | Seong K. Lee | Surgery | 1150 N 35th Ave, Suite 135, Hollywood, FL 33021-5424 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619422607 | Shawn A. Mcclure Dmd, Md | Surgery | 8755 Sw 57th Pl, Cooper City, FL 33328-5921 | 2016-08-18 |
| 1326434556 | Kyle Leneweaver | Surgery | 5151 N 9th Ave # 305, Pensacola, FL 32504-8721 | 2015-04-14 |
| 1093063869 | Ocala Health Trauma, LLC | Surgery | 205 Se 14th Pl, Ocala, FL 34471-4341 | 2012-08-27 |
| 1912262544 | Injury Management, LLC | Surgery | 4010 Nw 100th Ave, Coral Springs, FL 33065-1549 | 2012-07-10 |
| 1558664987 | Moshe Stav Md Pa | Surgery | 1550 Ponce De Leon Dr, 3200 S. University Dr, Rm 7374, Fort Lauderdale, FL 33316-1324 | 2010-12-07 |
| 1154589786 | Meredith Lynn Shaddix | Surgery | 5153 North 9th Avenue, Suite 305, Pensacola, FL 32504 | 2008-05-30 |
| 1760681225 | Omar Mahmoud El-sheikh | Surgery | 801 E. 6th Street, Suite 602, Panama City, FL 32401-3663 | 2007-07-15 |
| 1689710279 | Thomas Anthony Abbruzzese | Surgery | 1654 Village Center Dr Apt 207, Lakeland, FL 33803-2892 | 2007-01-30 |
| 1003900952 | Meredith Tinti | Surgery | 3627 University Blvd S Ste 500, Jacksonville, FL 32216-7405 | 2006-10-03 |
| 1194748947 | James Carver Boyd | Surgery | 2280 N 9th Ave, Pensacola, FL 32503-3949 | 2006-07-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.