Provider Demographics
NPI:1073566691
Name:CARBONELL-RAMIREZ, ARACELIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ARACELIS
Middle Name:
Last Name:CARBONELL-RAMIREZ
Suffix:
Gender:F
Credentials:MD
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 1305
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-1305
Mailing Address - Country:US
Mailing Address - Phone:787-426-0780
Mailing Address - Fax:
Practice Address - Street 1:STREET 152 KM 12 HM 2
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-5900
Practice Address - Fax:787-869-6120
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14549208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2 - 2181CAOtherTRIPLE-S
PR500486EOtherMMM
PR002 - 2181Medicare ID - Type Unspecified
PRI - 02091Medicare UPIN