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General NPI Number Information
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NPI Number | 1730249624
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Entity Type | Individual
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Provider Name | CARLOS E IFARRAGUERRI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 29 CALLE WASHINGTON STE 301 ASFORD MEDICAL CENTER
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City | SAN JUAN
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State | PR
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Zip | 00907-1509
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Country | US
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Telephone | 787-723-2167
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Fax |
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Provider Business Mailing Address
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Address Line | 182 CAMINO DEL MONTE URBANIZACION SABANERA
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City | CIDRA
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State | PR
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Zip | 00739-9475
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Country | US
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Telephone | 787-739-5555
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Fax | 787-739-5544
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2775
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License Number State | PR
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