Healthcare Provider Details

I. General information

NPI: 1477174167
Provider Name (Legal Business Name): CAROLINA SANCHEZ DIAZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 LUIS BARRERA S
CAYEY PR
00736-4615
US

IV. Provider business mailing address

PO BOX 19805
SAN JUAN PR
00910-1805
US

V. Phone/Fax

Practice location:
  • Phone: 787-705-0708
  • Fax: 787-705-0709
Mailing address:
  • Phone: 787-518-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23099
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: