Provider Demographics
NPI:1598841918
Name:BOU, CARLOS R (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:BOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:LE89 VIA PARIS
Mailing Address - Street 2:L'ANTIGUA, ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1451 AVE ASHFORD
Practice Address - Street 2:SECOND FLOOR, OR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1511
Practice Address - Country:US
Practice Address - Phone:787-722-2350
Practice Address - Fax:787-725-3630
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR13219207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology