Provider Demographics
NPI:1114915311
Name:AMARAL, CARMEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:E
Last Name:AMARAL
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 21107
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-1107
Mailing Address - Country:US
Mailing Address - Phone:787-765-5150
Mailing Address - Fax:787-751-9772
Practice Address - Street 1:71 CALLE ARZUAGA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3703
Practice Address - Country:US
Practice Address - Phone:787-765-5150
Practice Address - Fax:787-751-9772
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12852207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89602Medicare ID - Type Unspecified
G54784Medicare UPIN