MEDICARE: ESTHER N. CARLO

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	156FX1800X	Optician	45	PR

General Provider Information

NPI Number	:	1639461171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER N. CARLO

Provider Business Mailing Address
First Line	:	URB. BAYAMON GARDEN B-3 CALLE CASTIGLIONI
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00957-2520
Country	:	US
Telephone Number	:	787-730-0660
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. BAYAMON GARDEN B-3 CALLE CASTIGLIONI
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00957-2520
Country	:	US
Telephone Number	:	787-730-0660
Fax Number	:

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

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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