Provider Demographics
NPI:1437143245
Name:CALIMANO GUARDIOLA, CARLOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:CALIMANO GUARDIOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:A
Other - Last Name:CALIMANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:W5-5 CALLE PIO BAROJA
Mailing Address - Street 2:HUCARES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6802
Mailing Address - Country:US
Mailing Address - Phone:787-761-9583
Mailing Address - Fax:787-283-7401
Practice Address - Street 1:W5-5 CALLE PIO BAROJA
Practice Address - Street 2:HUCARES
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6802
Practice Address - Country:US
Practice Address - Phone:787-761-9583
Practice Address - Fax:787-283-7401
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5918208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR067006OtherCRUZ AZUL DE PR
PR9220021OtherHUMANA INSURANCE
PR2-7425OtherSSS INSURANCE
PR067006OtherCRUZ AZUL DE PR
PR9220021OtherHUMANA INSURANCE