CAROL DA COSTA MD PA
Medical Practice at 88 St, Miami, FL

License number
Florida ME73650
Category
Medical Practice
Type
Pediatrics
Owner
Name: DR. CAROL ANA DA COSTA GOMEZ MD
Title: PRESIDENT
Phone: (305) 752-6465
Address
Address
15671 SW 88Th St, Miami, FL 33196
National Provider ID: 1730267055
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Carol Da Costa, M.D., PA

Miami, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Feb 10, 1999
Addresses:
9084 SW 113 Ave, Miami, FL 33176
15671 N Kendall Dr, Miami, FL 33196
11200 SW 93 St, Miami, FL 33176
State ID:
P99000013273
Business type:
Domestic for Profit Corporation
Principal, President, Director, Secretarys:
Anthony Garcia (Treasurer, Vice President),Carol D. Costa Principal, President, Director, Secretary, inactive

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