Provider Demographics
NPI:1750505228
Name:ARGUELLO, CARLOS ROSENDO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ROSENDO
Last Name:ARGUELLO
Suffix:
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 1:5795 NW DOWSE ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3920
Mailing Address - Country:US
Mailing Address - Phone:772-346-7906
Mailing Address - Fax:
Practice Address - Street 1:10624 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-6401
Practice Address - Country:US
Practice Address - Phone:772-380-0920
Practice Address - Fax:772-380-0921
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25986207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine