Provider Demographics
NPI:1740229459
Name:PADILLA CARRERAS, JOSE L (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:L
Last Name:PADILLA CARRERAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:URB SANTA CRUZ #10
Mailing Address - Street 2:CALLE LAS ROSAS 1805
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-785-8530
Mailing Address - Fax:787-785-8530
Practice Address - Street 1:EDIFICIO MEDICO SANTA CRUZ #73
Practice Address - Street 2:CALLE SANTA CRUZ SUITE403
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-8530
Practice Address - Fax:787-785-8530
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2019-07-23
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Provider Licenses
StateLicense IDTaxonomies
PR10468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41625Medicare UPIN