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General NPI Number Information
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NPI Number | 1871651448
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Entity Type | Individual
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Provider Name | RAFAEL ORLANDO CARRILLO SR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | AVE. PONCE DE LEON 715 CLINICAS EXTERNAS HOSP. AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-319-7826
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 360903
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City | SAN JUAN
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State | PR
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Zip | 00936-0903
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Country | US
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Telephone | 787-319-7826
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 3773
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License Number State | PR
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