Provider Demographics
NPI:1447525670
Name:VINCENT DI CARLO, M.D. AND ASSOCIATES, P.A.
Entity type:Organization
Organization Name:VINCENT DI CARLO, M.D. AND ASSOCIATES, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-282-1916
Mailing Address - Street 1:2835 W DE LEON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4130
Mailing Address - Country:US
Mailing Address - Phone:813-831-6622
Mailing Address - Fax:813-873-1295
Practice Address - Street 1:2835 W DE LEON ST STE 205
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4130
Practice Address - Country:US
Practice Address - Phone:813-831-6622
Practice Address - Fax:813-873-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5178103T00000X
FLPY 6748103T00000X
FLME 643952084N0400X
FLOS 87932084N0400X
FLPT 26599225100000X
FLAY 31231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty