Provider Demographics
NPI:1760574131
Name:CARLO, MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:CARLO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PMB 509
Mailing Address - Street 2:P.O.BOX 7891
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-789-1919
Mailing Address - Fax:787-789-1921
Practice Address - Street 1:1 AVE CASA LINDA STE 101
Practice Address - Street 2:ENTRADA AMERICAN MILITARY ACADEMY
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8998
Practice Address - Country:US
Practice Address - Phone:787-789-1919
Practice Address - Fax:787-789-1921
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR151182080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine