Provider Demographics
NPI:1649247636
Name:MARIN, CARLOS E
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MARIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 COAST GUARD BLVD
Mailing Address - Street 2:USCGC NORTHLAND (WMEC 904)
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-2135
Mailing Address - Country:US
Mailing Address - Phone:757-407-0235
Mailing Address - Fax:
Practice Address - Street 1:4000 COAST GUARD BLVD
Practice Address - Street 2:USCGC NORTHLAND (WMEC 904)
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2135
Practice Address - Country:US
Practice Address - Phone:757-407-0235
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other