Raul Carrillo MD PA

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME87534 Issued in FL

Legal business name

RAUL CARRILLO MD PA

Practice address

929. N. Hwy 27/441
Suite 302
Lady Lake, FL 32159

Phone

(352) 391-1115

Fax

(352) 391-5206

NPI assigned

Nov 19, 2008

Last updated

Aug 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raul Carrillo, MD

Title

Ceo

Phone

(352) 391-1115

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1952556821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 N. HWY 27/441",
            "address_2": "SUITE 302",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598999",
            "telephone_number": "352-391-1115",
            "fax_number": "352-391-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929. N. HWY 27/441",
            "address_2": "SUITE 302",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-391-1115",
            "fax_number": "352-391-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAUL CARRILLO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-391-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME87534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267028300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammed Faisal Rahman, M.D.
• Shaquetta Rambo
• Oliver Calungcagin Ramoso, ARNP
• Melissa Carol Randolph, COTA
• Frank Ranfone
• Chelsea Ray, CPO
• Srinivas Reddy, M.D
• Christine Redlinger, CRNA
• Regenerative Health Services
• Rehab Care Specialist

• Pulmonary Disease Physician in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.