Provider Demographics
NPI:1184110868
Name:ARENCIBIA ALBITE, CARLOS JAVIER (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:JAVIER
Last Name:ARENCIBIA ALBITE
Suffix:
Gender:M
Credentials:MD
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 3975
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958
Mailing Address - Country:US
Mailing Address - Phone:787-944-2940
Mailing Address - Fax:
Practice Address - Street 1:D5-11 SAN FERNANDO GARDEN APARTMENTS
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-944-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21020208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice