Provider Demographics
NPI:1154796977
Name:DR. CARLOS J. CARRO PAGAN CSP
Entity type:Organization
Organization Name:DR. CARLOS J. CARRO PAGAN CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERVENTIONAL CARDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-844-2780
Mailing Address - Street 1:2225 PONCE BY PASS
Mailing Address - Street 2:ED. PARRA SUITE 905
Mailing Address - City:PONCE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00717
Mailing Address - Country:UM
Mailing Address - Phone:787-844-2780
Mailing Address - Fax:787-844-2832
Practice Address - Street 1:2225 AVENIDA PONCE BY PASS
Practice Address - Street 2:EDIFICIO PARRA SUITE 905
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-844-2710
Practice Address - Fax:787-844-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR246XC2901X261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC82775Medicare UPIN