Provider Demographics
NPI:1093938573
Name:MURILLO, LUIS CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:CARLOS
Last Name:MURILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 BAYOU BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1901
Mailing Address - Country:US
Mailing Address - Phone:850-477-9253
Mailing Address - Fax:850-494-9843
Practice Address - Street 1:4700 BAYOU BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503
Practice Address - Country:US
Practice Address - Phone:850-477-9253
Practice Address - Fax:850-494-9843
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44696207RP1001X
FLME134455207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease