Healthcare Provider Details

I. General information

NPI: 1346200235
Provider Name (Legal Business Name): CARLOS A ROURE LLOMPART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 AVE CESAR GONZALEZ SUITE 401
SAN JUAN PR
00919
US

IV. Provider business mailing address

P.O. BOX 7289
CAGUAS PR
00726
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-1920
  • Fax:
Mailing address:
  • Phone: 787-766-1920
  • Fax: 787-746-9172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4625
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: