Healthcare Provider Details

I. General information

NPI: 1053724658
Provider Name (Legal Business Name): CARLOS A MUNOZ TORRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #3 KM. 8.3 AVE 65 INFANTERIA
CAROLINA PR
00984-6021
US

IV. Provider business mailing address

PO BOX 249
SANTA ISABEL PR
00757-0249
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax:
Mailing address:
  • Phone: 787-341-1869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21722
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: