Diego Jose Carrillo Diaz, MD, BSN

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

17226-I Issued in PR

Practice address

St. Rd 2 KM. 173.4
San German, PR 00683

Phone

(787) 892-1860

NPI assigned

Aug 12, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1205667243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1353",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "006231353",
            "telephone_number": "787-538-9735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. RD 2 KM. 173.4",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO DIAZ",
        "first_name": "DIEGO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD, BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "17226-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in San German, PR
• Student in an Organized Health Care Education/Training Program in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.