Provider Demographics
NPI:1457450207
Name:CABAN ESPINOSA, CARMEN S (MD)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:S
Last Name:CABAN ESPINOSA
Suffix:
Gender:F
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 7037
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-7037
Mailing Address - Country:US
Mailing Address - Phone:787-762-8216
Mailing Address - Fax:787-257-3030
Practice Address - Street 1:CAROLINA CT & BREAST CLINIC
Practice Address - Street 2:CAROLINA SHOPPING COURT SUITE 023A
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-257-0677
Practice Address - Fax:787-257-3030
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34912085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR24135CMedicare ID - Type Unspecified
PR0055057Medicare PIN
D34235Medicare UPIN