Provider Demographics
NPI:1043773799
Name:ALBARRAN, CARLOS EDUARDO SR (MRC)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:ALBARRAN
Suffix:SR
Gender:M
Credentials:MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1991
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1991
Mailing Address - Country:US
Mailing Address - Phone:787-248-2102
Mailing Address - Fax:
Practice Address - Street 1:73 CALLE PAJAROS
Practice Address - Street 2:BO HATO TEJAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-248-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1549101Y00000X, 225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1549OtherREHABILITATION COUNSELOR LICENSE