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General NPI Number Information
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NPI Number | 1750379830
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Entity Type | Individual
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Provider Name | CARLOS TULIO VARGAS MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | A2 CALLE DR TROYER
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City | AIBONITO
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State | PR
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Zip | 00705-3304
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Country | US
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Telephone | 787-948-0400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 832
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City | ARECIBO
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State | PR
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Zip | 00613-0832
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Country | US
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Telephone | 787-948-0400
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 8109
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License Number State | PR
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