Provider Demographics
NPI:1619509924
Name:CHAVEZ ARIAS, CARLOS FERNANDO SR (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:FERNANDO
Last Name:CHAVEZ ARIAS
Suffix:SR
Gender:M
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:PO BOX 361538
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1538
Mailing Address - Country:US
Mailing Address - Phone:787-567-0411
Mailing Address - Fax:
Practice Address - Street 1:1195 CALLE 54 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3140
Practice Address - Country:US
Practice Address - Phone:787-567-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17808207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology