Carlos Omar Aguiar Gutierrez, MD
Individual provider Active NPI General Practice Physician · San Juan, PR
NPI 1962993774 · NPPES record last updated May 29, 2020
Key facts
- NPI
- 1962993774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 21687 (PR)
- Practice address
- 672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926 - Phone
- (787) 362-9849
- NPI assigned
- May 29, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
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 |
|---|---|---|---|---|
| I20200921002007 | PR | Practitioner - General Practice | 3678991866 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21687 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zenith Health Group LLC | Single Specialty | Current |
Accepting new patients |
| Centro Medico del Turabo Inc | Single Specialty | Current |
Accepting new patients |
| Centro Medico del Turabo Inc | Current |
Accepting new patients | |
| MM Health Services, LLC. | Current |
Accepting new patients | |
| MM Health Services LLC | Single Specialty | Current |
Accepting new patients |
| Dla Imaging LLC | Single Specialty | Past |
Accepting new patients |
Locations
100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | 21687 | PR | Yes |
Addresses
Primary practice location
672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926
Mailing address
672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926
Phone (787) 362-9849
Other providers in San Juan, PR
- Fabiola Agramonte Bravo
- Tanzania P Agramonte
- Javier Enrique Agrelo Brignoni
- Aguadilla Cardio Imaging,PSC
- Pia Chantal Aguayo Gomez
- Maria Isabel Aguilar Pescozo
- Eliam Lazaro Aguilar Rollero
- Daniel E Aguilar-Aes
- Stephanie Milmar Aguilar
- Marvin Alameda
All providers in San Juan, 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 May 29, 2020. 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.