Provider Demographics
NPI:1154541498
Name:MONTALVO QUILES, CARMEN IVETTE (MD)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:IVETTE
Last Name:MONTALVO QUILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 VALLES DE TORRIMAR
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-798-8118
Mailing Address - Fax:
Practice Address - Street 1:600 DR. HERNAN CORTES
Practice Address - Street 2:A LA ORDEN SHOPPING 102
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00950
Practice Address - Country:US
Practice Address - Phone:787-779-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14243208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice