Provider Demographics
NPI:1396027769
Name:CARRILLO-SANCHEZ, EDWIN (DC)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:CARRILLO-SANCHEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55000
Mailing Address - Street 2:PMB 007
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0497
Mailing Address - Country:US
Mailing Address - Phone:787-632-8807
Mailing Address - Fax:
Practice Address - Street 1:CARR. 185 INT 954 KM 1.2
Practice Address - Street 2:BO. CANOVANILLAS
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-632-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor