Provider Demographics
NPI:1801099957
Name:CARLOS REMEDIOS CSP
Entity type:Organization
Organization Name:CARLOS REMEDIOS CSP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:REMEDIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-813-4401
Mailing Address - Street 1:PMB 140 APT 2000
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715
Mailing Address - Country:US
Mailing Address - Phone:787-813-4401
Mailing Address - Fax:787-813-4403
Practice Address - Street 1:PMB 140 APT 2000
Practice Address - Street 2:
Practice Address - City:MERCEDITA
Practice Address - State:PR
Practice Address - Zip Code:00715
Practice Address - Country:US
Practice Address - Phone:787-813-4401
Practice Address - Fax:787-813-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR102362085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2483OtherPREFERRED