Provider Demographics
NPI:1477286011
Name:CARRO MENDOZA, ANTONIO JOSE
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:JOSE
Last Name:CARRO MENDOZA
Suffix:
Gender:M
Credentials:
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 9924
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE EL CASTILLO 500
Practice Address - Street 2:EDIFICIO 13 APT. 10
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-6764
Practice Address - Country:US
Practice Address - Phone:787-328-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program