Provider Demographics
NPI:1467648659
Name:CARRION, IDALIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:IDALIA
Middle Name:
Last Name:CARRION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CALLE 8E
Mailing Address - Street 2:APT 3D
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1934
Mailing Address - Country:US
Mailing Address - Phone:787-751-7978
Mailing Address - Fax:
Practice Address - Street 1:445 CALLE 8E
Practice Address - Street 2:APT 3D COND SAN AGUSTIN
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-1934
Practice Address - Country:US
Practice Address - Phone:787-751-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2284208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics