Healthcare Provider Details

I. General information

NPI: 1568677946
Provider Name (Legal Business Name): CIRILO ENCARNACION KUILAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. ESTATAL # 2 BO. JUAN SANCHEZ
BAYAMON PR
00960
US

IV. Provider business mailing address

153 CALLE WASHINTONIA BOSQUE DE LAS PALMAS
BAYAMON PR
00956-9258
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-8250
  • Fax:
Mailing address:
  • Phone: 787-799-4201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number12368
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: