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Dr. Carmen C Vivero, MD
Addiction Medicine (Internal Medicine) Physician in St Augustine, Florida
NPI 1316012743

Carmen C Vivero is an Addiction Medicine (Internal Medicine) Physician based in St Augustine, FL and is specialized in Addiction Medicine. Carmen C Vivero practices in St Augustine, FL and has the professional credentials of MD. The NPI Number for Carmen C Vivero is 1316012743 and holds a License No. ME0076599 (Florida).

The current practice location address for Carmen C Vivero is 1301 Plantation Island Dr S, St Augustine, FL and can be reached out via phone at 904-460-0707 and via fax at 904-460-0727.

Location: 1301 Plantation Island Dr S, St Augustine, FL, 32080-3108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316012743
Provider Name
Carmen C Vivero
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1301 Plantation Island Dr S, St Augustine, FL, 32080-3108
Phone Number
904-460-0707
Fax Number
904-460-0727
Provider Enumeration Date
11/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
281237100 05 FL
DN9360 01 FL RR MEDICARE
44784 01 FL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1301 Plantation Island Dr S
City
St Augustine
State
Florida
Zip
32080-3108
Phone Number
904-460-0707
Fax Number
904-460-0727
person
Provider Business Mailing Address Details
Address
1301 Plantation Island Dr S
City
St Augustine
State
Florida
Zip
32080-3108
Phone Number
904-460-0707
Fax Number
904-460-0727
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Addiction Medicine
Taxonomy
207RA0401X
License No.
ME0076599 (Florida)
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
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