Fernando Carreras Coello – General Practice Physician

Key facts

NPI: 1891779427
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Physician 208D00000X
License: 7495 (PR)
Practice address: 103 Guillermo Esteves
Jayuya, PR 00664
Phone: (787) 828-7315
Fax: (787) 828-7315
NPI assigned: Dec 6, 2005
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20120221000938	PR	Practitioner - General Practice	4981862026	Practice locations: Jayuya, PR

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
7495	PR	MD	Pharmacy Technician

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Physician	208D00000X	7495	PR	Yes

Addresses

Primary practice location

103 Guillermo Esteves
Jayuya, PR 00664

Mailing address

PO Box 1528
Jayuya, PR 00664-2528
Phone (787) 828-7315

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 14, 2010.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1891779427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1528",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "006642528",
            "telephone_number": "787-828-7315",
            "fax_number": "787-828-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GUILLERMO ESTEVES",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "00664",
            "telephone_number": "787-828-7315",
            "fax_number": "787-828-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERAS COELLO",
        "first_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "7495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jayuya, PR

Gabriela Alejandra Andujar Zamora, PSY D
Sheila Arroyo
Frances Yamary Aviles, OTAL
Felix Juan Bonilla Acevedo, MD
Nilda I. Carreras-Coello, M.D.
Fernando Luis Carreras
CDT Mario Canales Torresola
Central Primary Care Group, Inc.
Maria A Colon Ojeda

All providers in Jayuya, PR · General Practice Physician in Puerto Rico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.