MEDICARE: DR. CARLOS SANCHEZ SERGENTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	6100	PR

General Provider Information

NPI Number	:	1477678803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS SANCHEZ SERGENTON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 366915
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-6915
Country	:	US
Telephone Number	:	787-764-9454
Fax Number	:	787-764-9454

Provider Business Practice Location Address
First Line	:	24 CALLE 1
Second Line	:	VILLAS LOS OLMOS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4605
Country	:	US
Telephone Number	:	787-764-9454
Fax Number	:	787-764-9454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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