Provider Demographics
NPI:1538295191
Name:BONET, CARLOS R (RFO)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:R
Last Name:BONET
Suffix:
Gender:M
Credentials:RFO
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 356
Mailing Address - Street 2:CARR. 115 KM 12.0
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0356
Mailing Address - Country:US
Mailing Address - Phone:787-823-5917
Mailing Address - Fax:787-823-3570
Practice Address - Street 1:STREET #115 KM 12.0
Practice Address - Street 2:SUITE #7
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677-0356
Practice Address - Country:US
Practice Address - Phone:787-823-5917
Practice Address - Fax:787-823-3570
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07P1793332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4353160001Medicare NSC