Provider Demographics
NPI:1417923442
Name:CARRION, JOSE L (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:L
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 1:1364 CALLE 18 NOROESTE
Mailing Address - Street 2:PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2238
Mailing Address - Country:US
Mailing Address - Phone:787-782-1067
Mailing Address - Fax:787-775-0093
Practice Address - Street 1:1364 CALLE 18 NOROESTE
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2238
Practice Address - Country:US
Practice Address - Phone:787-782-1067
Practice Address - Fax:787-775-0093
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant