Provider Demographics
NPI:1639671506
Name:GARNIER, CARLINE
Entity Type:Individual
Prefix:
First Name:CARLINE
Middle Name:
Last Name:GARNIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CIUDAD UNIVERSITARIA
Mailing Address - Street 2:B-10 CALLE A ESTE
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CHEZ MINI MALL
Practice Address - Street 2:3 CARR 174 KM 5.0
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00958
Practice Address - Country:US
Practice Address - Phone:787-798-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory