Provider Demographics
NPI:1336421726
Name:MATOS-RODRIGUEZ, CARLA M (MD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:M
Last Name:MATOS-RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 149793
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4793
Mailing Address - Country:US
Mailing Address - Phone:787-410-6469
Mailing Address - Fax:787-622-3490
Practice Address - Street 1:419 AVE PONCE DE LEON
Practice Address - Street 2:EDIFICIO METROPOLIS STE 102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3436
Practice Address - Country:US
Practice Address - Phone:787-754-0725
Practice Address - Fax:787-622-3490
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR19267208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation