Luis Carrasquillo
Individual provider Active NPI Dentist · Carolina, PR
NPI 1669445128 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669445128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1130 (PR)
- Practice address
- 89 Carolina CT
Carolina, PR 00982-3500 - Phone
- (787) 757-0548
- Fax
- (787) 760-0574
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1130 | PR | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1130 | PR | Yes |
Addresses
Primary practice location
89 Carolina CT
Carolina, PR 00982-3500
Mailing address
Calle 220 4Q42 Colinas de Fair View
San Juan, PR 00976
Phone (787) 760-0574
Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.