MEDICARE: DR. CARLOS E ROBLES-MORA MD, MRO, CIME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	5636	PR

General Provider Information

NPI Number	:	1659496453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS E ROBLES-MORA MD, MRO, CIME

Provider Business Mailing Address
First Line	:	PO BOX 6557
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-6557
Country	:	US
Telephone Number	:	787-379-1543
Fax Number	:	787-745-9380

Provider Business Practice Location Address
First Line	:	ANGEL L ORTIZ A-6
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-379-1543
Fax Number	:	787-745-9380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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