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General NPI Number Information
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NPI Number | 1821000993
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Entity Type | Individual
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Provider Name | JOSE LUIS CARLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 294 AVE LAURO PINERO
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City | CEIBA
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State | PR
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Zip | 00735-2703
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Country | US
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Telephone | 787-885-2573
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Fax | 787-885-2573
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Provider Business Mailing Address
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Address Line | PO BOX 414
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City | CEIBA
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State | PR
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Zip | 00735-0414
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Country | US
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Telephone | 787-885-2573
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Fax | 787-885-2573
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 6008
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License Number State | PR
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