Provider Demographics
NPI:1023139896
Name:CARLO, SIMON E (MD)
Entity type:Individual
Prefix:DR
First Name:SIMON
Middle Name:E
Last Name:CARLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0911
Mailing Address - Country:US
Mailing Address - Phone:787-635-3680
Mailing Address - Fax:787-728-8316
Practice Address - Street 1:252 SAN JORGE ST.
Practice Address - Street 2:SUITE 408
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-728-8316
Practice Address - Fax:787-728-8316
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12584207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics