Carlos a Vizcarra MD PA – Internal Medicine Physician

Key facts

NPI: 1437248754
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: ME 931719 (FL)
Legal business name: CARLOS A VIZCARRA MD PA
Practice address: 13837 US Highway 1
Sebastian, FL 32958-3232
Phone: (772) 589-9188
Fax: (772) 589-9187
NPI assigned: Oct 12, 2006
Organization subpart: No

Authorized official

Name: Dr. Carlos Andres Vizcarra, M.D.
Title: President
Phone: (772) 589-9188

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Carlos Andres Vizcarra PA, M.D Internal Medicine Physician · Sebastian, FL · NPI 1891729752

Medicare reassignment Care Compare group NPD FL · INTERNAL MEDICINE
Penny Walker, ARNP Family Nurse Practitioner · Palm Bay, FL · NPI 1194149070

Medicare reassignment Care Compare group NPD FL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20070214000232	FL	Part B Supplier - Clinic/Group Practice	0446252837	Receives reassigned benefits from 2 practitioners Practice locations: Sebastian, FL

National Provider Directory

Locations

13000 US Highway 1
Ste 4
Sebastian, FL 32958
Phone (772) 388-4000

13000 US Highway 1
Ste 100
Sebastian, FL 32958

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X	ME 931719	FL	Yes

Addresses

Primary practice location

13837 US Highway 1
Sebastian, FL 32958-3232

Mailing address

3897 Peacock Dr
Melbourne, FL 32904-9516
Phone (321) 373-1160

Other providers in Sebastian, FL

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William Douglas Canterbury-Counts, PH.D.
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Care 101 Home Health
Care Coordination Management Group
Jennifer Leigh Carter, D.C.
Ashley Casey
Valerie Ann Castellano, COTA/L
Keren Elizabeth Castellucci, D.M.D.
Claudia Yolanda Castro, M.D.

All providers in Sebastian, FL · Internal Medicine Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.