Healthcare Provider Details

I. General information

NPI: 1912910621
Provider Name (Legal Business Name): ERIC J CARRO JIMENEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 AVE DE DIEGO STE 230
SAN JUAN PR
00927-6327
US

IV. Provider business mailing address

1913 CALLE PLATANILLO EXT. SANTA MARIA
SAN JUAN PR
00927-6616
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-2882
  • Fax: 787-705-7135
Mailing address:
  • Phone: 787-644-4579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15117
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA104101
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number15117
License Number StatePR
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number15117
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: