NPIMap

Organization Active NPI

Octavio Carreno MD PA

  • Specialist
  • Orange Park, FL
National Provider Identifier
1023210804
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME78105 Issued in FL
Legal business name
OCTAVIO CARRENO MD PA
Practice address
2035 Professional Center Dr
Suite a
Orange Park, FL 32073-4492
Phone
(904) 272-3200
Fax
(904) 272-3211
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Connie Adkins
Title
Office Manager
Phone
(904) 272-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME78105 FL Primary

Addresses

Primary practice location

2035 Professional Center Dr
Suite a
Orange Park, FL 32073-4492

Mailing address

2035 Professional Center Dr
Suite a
Orange Park, FL 32073-4492
Phone (904) 272-3200

National Provider Directory

National Provider Directory

Locations

2035 Professional Center Dr
Ste A
Orange Park, FL 32073
Phone (904) 272-3200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1023210804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 PROFESSIONAL CENTER DR",
            "address_2": "SUITE A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734492",
            "telephone_number": "904-272-3200",
            "fax_number": "904-272-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 PROFESSIONAL CENTER DR",
            "address_2": "SUITE A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734492",
            "telephone_number": "904-272-3200",
            "fax_number": "904-272-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTAVIO CARRENO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-272-3200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME78105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.