Provider Demographics
NPI:1023095692
Name:MICAMES MUZABER, CARLOS (MD, FACP)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:MICAMES MUZABER
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1092
Mailing Address - Country:US
Mailing Address - Phone:787-833-4865
Mailing Address - Fax:787-265-4757
Practice Address - Street 1:55 CALLE DR BASORA 55 NORTE EDICICIO MEDICO IV
Practice Address - Street 2:SUITE 111
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-0111
Practice Address - Country:US
Practice Address - Phone:787-833-4865
Practice Address - Fax:787-265-4757
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5613207RG0100X
PR005613207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0097270Medicare PIN
PRE-20115Medicare UPIN