OCTAVIO B CARRENO MD PA
Medical Practice at Miami Ave, Miami, FL

License number
Florida ME0014312
Category
Medical Practice
Type
Ophthalmology
Owner
Name: OCTAVIO B CARRENO MD PA
Title: PRESIDENT
Phone: (305) 854-4555
Address
Address
3661 SOUTH Miami Ave STE 601, Miami, FL 33133
National Provider ID: 1568494805
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OCTAVIO B. CARRENO, M.D., PA

3661 S Miami Ave SUITE 601, Miami, FL 33133

Status:
Inactive
Industry:
Medical Doctor's Office, Nonclassifiable Establishments
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jun 30, 1978
Inactive since:
Sep 14, 2007
State ID:
577785
Business type:
Florida Profit Corporation
President:
Octavio B. Carreno President, inactive, 3661 S Miami Ave, Miami, FL (Physical)
Agent:
Intrastate Registered Agent Corporation,701 Brickell Ave SUITE 3000, Miami, FL 33131 (Physical)
EIN:
591833940

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