Provider Demographics
NPI:1770582645
Name:ROBLES-RIVERA, CARLOS R (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:ROBLES-RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 51090
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1090
Mailing Address - Country:US
Mailing Address - Phone:787-636-4797
Mailing Address - Fax:787-283-2307
Practice Address - Street 1:431 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 328
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3418
Practice Address - Country:US
Practice Address - Phone:787-751-8086
Practice Address - Fax:787-283-2307
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13215207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PROTH000Medicare UPIN