Healthcare Provider Details

I. General information

NPI: 1780504449
Provider Name (Legal Business Name): CARLOS JAVIER GARCIA LAUREANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KM 11.7 PR-2
BAYAMON PR
00959
US

IV. Provider business mailing address

KM 11.7 PR-2
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-8181
  • Fax:
Mailing address:
  • Phone: 787-620-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number6906
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: