Provider Demographics
NPI:1245225614
Name:BOURDONY-BAEZ, CARLOS J (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:J
Last Name:BOURDONY-BAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11021
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-2121
Mailing Address - Country:US
Mailing Address - Phone:787-433-7334
Mailing Address - Fax:787-727-6550
Practice Address - Street 1:258 CALLE SAN JORGE SUITE 205
Practice Address - Street 2:SAN JORGE CHILDREN HOSPITAL TOWER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1900
Practice Address - Country:US
Practice Address - Phone:787-433-7334
Practice Address - Fax:787-727-6550
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2016-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR41202080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology