Healthcare Provider Details

I. General information

NPI: 1043200595
Provider Name (Legal Business Name): ZAIDA I CARRION MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ATLANTIC MEDICAL CENTER
BARCELONETA PR
00617-0000
US

IV. Provider business mailing address

200 CALLE MONSERRATE URB PLAZUELA ESTATES
BARCELONETA PR
00617-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-4412
  • Fax: 787-970-4412
Mailing address:
  • Phone: 787-846-4412
  • Fax: 787-970-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15762
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier15762
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: