Provider Demographics
NPI:1942260450
Name:CARLO-CHEVERE, VICTOR JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JOSE
Last Name:CARLO-CHEVERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 CALLE LOIZA
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1801
Mailing Address - Country:US
Mailing Address - Phone:787-602-3768
Mailing Address - Fax:787-728-6031
Practice Address - Street 1:1760 CALLE LOIZA
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1801
Practice Address - Country:US
Practice Address - Phone:787-602-3768
Practice Address - Fax:787-728-6031
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13216207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH07914Medicare UPIN
PR8-0311Medicare ID - Type Unspecified