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General NPI Number Information
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NPI Number | 1063480614
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Entity Type | Individual
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Provider Name | CARLOS R LAGUILLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 08/25/2024
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Provider Practice Location Address
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Address Line | 29 CALLE BETANCES
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City | UTUADO
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State | PR
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Zip | 00641-2862
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Country | US
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Telephone | 939-281-0797
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 934
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City | ARECIBO
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State | PR
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Zip | 00613-0934
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Country | US
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Telephone | 787-215-6629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 10084
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License Number State | PR
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