OCTAVIO DE JESUS CARRENO (NPI# 1629039409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629039409 |
| Entity Type | Individual |
| Full Name | OCTAVIO DE JESUS CARRENO |
| Credential | M.D |
| Practice Address |
3100 Sw 62nd Ave Ste 124 Miami FL 33155 |
| Mailing Address |
3100 Sw 62nd Ave. Ste 124 Miami FL 33155 |
| Practice Telephone | 3056628316 |
| Practice Fax Number | 3056638513 |
| Mailing Telephone | 3056628316 |
| Mailing Fax Number | 3056638513 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2014-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
ME78105 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 432628999 | 05 |
| Street Address |
3100 SW 62ND AVE STE 124 |
| City | MIAMI |
| State | FL |
| Zip Code | 33155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824077 | Rene Luis Lopez-guerrero | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2005-07-13 |
| 1598366239 | Alejandra Margarita Patterson | Registered Nurse | 3100 Sw 62nd Ave, Suite 108 Center for Spinal Disorders, Miami, FL 33155 | 2020-11-07 |
| 1093315947 | Mailys Santoro | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-29 |
| 1174121289 | Lilia M Mendoza | Family Medicine | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1932707007 | Brian Ruiz | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1457965345 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-09-08 |
| 1306459177 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1568075372 | Nancy Pierre | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1841803335 | Dicle Yasar Aksoyler | Student in an Organized Health Care Education/Training Program | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-25 |
| 1154932952 | Veronica A Quintanar Sanabria | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987121 | Blanca Argentina Torres | Speech-Language Pathologist | 6840 Bird Rd Unit 211a, Miami, FL 33155 | 2020-09-21 |
| 1245888585 | Mila De La Caridad Broche Coego | Behavior Technician | 2247 Sw 68th Ct, Miami, FL 33155 | 2019-08-29 |
| 1265087878 | Nancy Acela Denis | Nurse Practitioner | 6791 Sw 25 Terra, Miami, FL 33155 | 2019-08-09 |
| 1700366887 | Aly Hashim | Family Medicine | 2805 Sw 75th Avenue, Miami, FL 33155 | 2018-08-17 |
| 1184115362 | Ready 2 Transfer, Inc. | Non-emergency Medical Transport (VAN) | 7811 Sw 24 Street #120, Miami, FL 33155 | 2018-05-23 |
| 1053808030 | Idalmis Pimentel Diez | Behavior Technician | 6334 Sw 30th St, Miami, FL 33155 | 2018-04-16 |
| 1225538689 | L & L Social Services LLC | Case Management | 5950 Sw 40 St, Miami, FL 33155 | 2018-02-12 |
| 1659888915 | Red Bird Dental Care | Dentist | 5771 Sw 40 St, Miami, FL 33155 | 2018-01-08 |
| 1043726474 | Jesenia Rodriguez-vila | Nurse Practitioner | 6433 Sw 29th St, Miami, FL 33155 | 2017-12-21 |
| 1326553736 | Believe Neuro-behavioral Services | Behavioral Analyst | 6700 Sw 38th St, Miami, FL 33155 | 2017-12-07 |
| Find all providers in zip 33155 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710905187 | David J Arnold | Otolaryngology | 1666 Nw 10 Ave, Miami, FL 33136 | 2006-07-17 |
| 1174549224 | Francisco J Civantos | Otolaryngology | 1666 Nw 10 Ave, Box 016960 (m851), Miami, FL 33136 | 2006-07-14 |
| 1902830375 | W Jarrard Goodwin | Otolaryngology | 1666 Nw 10 Ave, Box 016960 (m851), Miami, FL 33101-6960 | 2006-07-10 |
| 1972537348 | Donald T Weed | Otolaryngology | 1666 Nw 10 Ave, Miami, FL 33101-6960 | 2006-07-10 |
| 1003863093 | Lisa D Grunebaum | Otolaryngology | 1666 Nw 10th Ave, Box 016960 M851, Miami, FL 33136-1015 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317479 | Ent Associates Pa | Otolaryngology | 3390 Tamiami Trl Ste 201-202, Port Charlotte, FL 33952-8157 | 2019-10-13 |
| 1679878615 | Herbert Kean | Otolaryngology | 799 Crandon Blvd, Apt 1407, Key Biscayne, FL 33149 | 2011-01-24 |
| 1881784841 | Scott Jeffery Trimas | Otolaryngology | 1361 13th Ave South, Ste 125, Jacksonville, FL 32250 | 2006-10-13 |
| 1225032006 | Rangaswamy Asokan | Otolaryngology | 2651 Sw 32nd Pl, Ocala, FL 34471 | 2005-06-09 |
| 1851818686 | Accent Physician Specialists, P.a. | Otolaryngology | 3304 Sw 34th Cir Ste 103, Ocala, FL 34474-3357 | 2017-08-23 |
| 1720527021 | Randall P Weyrich Md LLC | Otolaryngology | 6602 Seabird Way, Apollo Beach, FL 33572-3003 | 2017-02-20 |
| 1326416413 | Edward H. Farrior, Md, Pa | Otolaryngology | 2908 W Azeele St, Tampa, FL 33609-3110 | 2015-09-08 |
| 1528442332 | Genesiscare of Florida LLC | Otolaryngology | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2015-07-13 |
| 1225448921 | The Palm Beach Center for Facial Plastic & Laser Surgery, P.a. | Otolaryngology | 4495 Military Trl Ste 202, Jupiter, FL 33458 | 2014-05-02 |
| 1801219944 | Edward J. Gross, M.d., P.l. | Otolaryngology | 1035 Primera Blvd, Lake Mary, FL 32746-2193 | 2014-01-25 |
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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.