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General NPI Number Information
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NPI Number | 1811374341
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Entity Type | Individual
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Provider Name | SYRELL JEANNETTE RODRIGUEZ CARRERAS MD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1220 LEE ST E STE 208
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City | CHARLESTON
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State | WV
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Zip | 25301-1864
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Country | US
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Telephone | 304-388-7270
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 BELLEVIEW AVE SE
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City | ROANOKE
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State | VA
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Zip | 24014-1838
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Country | US
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Telephone | 724-988-9429
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Fax | 717-851-3559
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101269570
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 31046
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT208260
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License Number State | PA
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