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NPI Code Detail

MEDICARE: DR. CARLOS R MENDEZ-BUSO M.D.

MEDICARE: DR. CARLOS R MENDEZ-BUSO M.D.
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
12085R0202XDiagnostic Radiology Physician15846PR
22085U0001XDiagnostic Ultrasound Physician15846PR

General Provider Information

NPI Number : 1861479503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS R MENDEZ-BUSO M.D.
Provider Business Mailing Address
First Line : PO BOX 6798
Second Line :
City : SAN JUAN
State : PR
Zip : 00914-6798
Country : US
Telephone Number : 787-236-7349
Fax Number :
Provider Business Practice Location Address
First Line : 70 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-7052
Country : US
Telephone Number : 787-620-4747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 12/23/2010

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