Carlos R Vergne LLC

Organization Active NPI General Practice Physician · Juana Diaz, PR

NPI 1699535526 · NPPES record last updated Jan 13, 2026

Key facts

NPI
1699535526
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
CARLOS R VERGNE LLC
Practice address
100 Calle Comercio
Local 5
Juana Diaz, PR 00795-1679
Phone
(787) 260-0480
Fax
(787) 813-1010
NPI assigned
Mar 19, 2024
Organization subpart
No

Authorized official

Name
Carlos R Vergne Sotomayor, MD
Title
President
Phone
(787) 363-6629

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20241024000001 PR Part B Supplier - Clinic/Group Practice 7113450545 Receives reassigned benefits from 2 practitioners
Practice locations: Juana Diaz, PR

National Provider Directory

Locations

100 Calle Comercio
#5
Juana Diaz, PR 00795
Phone (787) 260-0480

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

100 Calle Comercio
Local 5
Juana Diaz, PR 00795-1679

Mailing address

109 Palacios del Prado
Juana Diaz, PR 00795-2118
Phone (787) 260-0480

Other identifiers

IdentifierTypeStateIssuer
039737200MedicaidPR

Other providers in Juana Diaz, PR

All providers in Juana Diaz, PR · General Practice Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.