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General NPI Number Information
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NPI Number | 1710374806
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Entity Type | Individual
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Provider Name | CARLA MARGARITA ROSARIO-ILLANAS MD
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Gender | Female
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 3018 AVE ISLA VERDE
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City | CAROLINA
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State | PR
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Zip | 00979-4844
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Country | US
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Telephone | 787-726-7438
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Fax | 787-726-2827
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Provider Business Mailing Address
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Address Line | PO BOX 79709
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City | CAROLINA
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State | PR
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Zip | 00984-9709
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Country | US
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Telephone | 787-726-7438
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Fax | 787-726-2827
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 19786
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License Number State | PR
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