Healthcare Provider Details

I. General information

NPI: 1003339995
Provider Name (Legal Business Name): CARLA R. NARVAEZ-ROSARIO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 CALLE DE DIEGO N
CAROLINA PR
00985-6032
US

IV. Provider business mailing address

54 CALLE DE DIEGO N
CAROLINA PR
00985-6032
US

V. Phone/Fax

Practice location:
  • Phone: 787-769-4528
  • Fax:
Mailing address:
  • Phone: 787-769-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number19752
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: