Provider Demographics
NPI:1346277407
Name:CARRION, CARLOS EUGENIO (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:EUGENIO
Last Name:CARRION
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:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-285-4180
Mailing Address - Fax:787-285-4165
Practice Address - Street 1:55 CALLE ULISES MARTINEZ N
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3644
Practice Address - Country:US
Practice Address - Phone:787-893-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15551208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3645OtherPREFERRED MEDICARE CHOICE
PR0023399Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PR3645OtherPREFERRED MEDICARE CHOICE