Provider Demographics
NPI:1346641305
Name:OLIVARES ALMANZAR, CARLOS JOSE (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:JOSE
Last Name:OLIVARES ALMANZAR
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 1:29 CALLE WASHINGTON
Mailing Address - Street 2:STE 207
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1509
Mailing Address - Country:US
Mailing Address - Phone:787-722-1104
Mailing Address - Fax:
Practice Address - Street 1:29 CALLE WASHINGTON STE 207
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1509
Practice Address - Country:US
Practice Address - Phone:787-722-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21379207V00000X
PR33059207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology