Provider Demographics
NPI:1982762563
Name:CARLO, VICTOR P (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:P
Last Name:CARLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:16 CALLE A
Mailing Address - Street 2:URB. GARCIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5102
Mailing Address - Country:US
Mailing Address - Phone:787-753-5336
Mailing Address - Fax:
Practice Address - Street 1:735 AVE PONCE DE LEON
Practice Address - Street 2:OLD BUILDING THIRD FLOOR
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-767-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15341207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology