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General NPI Number Information
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NPI Number | 1669098927
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Entity Type | Individual
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Provider Name | CARLOS FAURA
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Gender | Male
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 833 KM 12.4 BO FRAILES
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City | GUAYNABO
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State | PR
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Zip | 00971
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Country | US
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Telephone | 787-510-0600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10335
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City | SAN JUAN
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State | PR
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Zip | 00922-0335
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Country | US
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Telephone | 787-510-0600
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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 | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number |
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License Number State | PR
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