Provider Demographics
NPI:1912910621
Name:CARRO JIMENEZ, ERIC J (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:CARRO JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 CALLE PLATANILLO
Mailing Address - Street 2:EXT. SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6616
Mailing Address - Country:US
Mailing Address - Phone:787-644-4579
Mailing Address - Fax:
Practice Address - Street 1:85 AVE DE DIEGO STE 230
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6327
Practice Address - Country:US
Practice Address - Phone:787-400-2882
Practice Address - Fax:787-705-7135
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15117207R00000X, 207RC0000X, 207RI0011X
CAA104101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH99100Medicare UPIN
PR22151Medicare ID - Type Unspecified