Provider Demographics
NPI:1942274584
Name:GONZALEZ-CARBIA, ADALBERTO RAFAEL SR (MD)
Entity Type:Individual
Prefix:MR
First Name:ADALBERTO
Middle Name:RAFAEL
Last Name:GONZALEZ-CARBIA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0374
Mailing Address - Country:US
Mailing Address - Phone:787-897-2068
Mailing Address - Fax:787-897-2068
Practice Address - Street 1:8 VILELLA STREET
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-0374
Practice Address - Country:US
Practice Address - Phone:787-897-2068
Practice Address - Fax:787-897-2068
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR3910208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C79409Medicare UPIN