Provider Demographics
NPI:1740462522
Name:CARRASQUILLO-NAVARRO, ORLANDO J (MD)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:J
Last Name:CARRASQUILLO-NAVARRO
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 1311
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1311
Mailing Address - Country:US
Mailing Address - Phone:787-367-0787
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY #1 BO. MONTE LLLANO KM 55.2
Practice Address - Street 2:PLAZA CAYEY CARIBBEAN CINEMAS BUILDING SUITE #202
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-367-0787
Practice Address - Fax:787-694-7045
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17470207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRGD295AMedicare PIN