Healthcare Provider Details

I. General information

NPI: 1538295191
Provider Name (Legal Business Name): CARLOS R. BONET RFO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET #115 KM 12.0 SUITE #7
RINCON PR
00677-0356
US

IV. Provider business mailing address

PO BOX 356 CARR. 115 KM 12.0
RINCON PR
00677-0356
US

V. Phone/Fax

Practice location:
  • Phone: 787-823-5917
  • Fax: 787-823-3570
Mailing address:
  • Phone: 787-823-5917
  • Fax: 787-823-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number07P1793
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: