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General NPI Number Information
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NPI Number | 1720130842
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Entity Type | Individual
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Provider Name | GUILLERMO ENRIQUE CARRASQUILLO II DPM
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 8133 CALLE CONCORDIA STE 201
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City | PONCE
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State | PR
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Zip | 00717-1543
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Country | US
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Telephone | 787-843-7770
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Fax | 787-680-0197
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | MERCEDITA
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State | PR
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Zip | 00715-0429
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Country | US
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Telephone | 787-843-7770
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 000645
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 00000048
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License Number State | PR
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