Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 8956 | PR |
NPI | 1023090545 |
---|---|
Provider Name | Mr. Enrique Carbonell |
First Address | Mayaguez, PR 00681-0177 |
Second Address | Mayaguez, PR 00681 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |