1518048800 NPI number — DR. CARLOS CARPINTERO DIAZ MD

Table of content: DR. CARLOS CARPINTERO DIAZ MD (NPI 1518048800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518048800 NPI number — DR. CARLOS CARPINTERO DIAZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARPINTERO DIAZ
Provider First Name:
CARLOS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518048800
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3501 W VINE ST
Provider Second Line Business Mailing Address:
STE 226
Provider Business Mailing Address City Name:
KISSIMMEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34741-4633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-530-4802
Provider Business Mailing Address Fax Number:
407-530-4910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
C-1 AVE. AGUSTIN PEREZ ANDINO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIO GRANDE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-888-3993
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  7195 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 068824 . This is a "ID NUMBER FOR CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7450020 . This is a "ID NUMBER FOR HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 500001E . This is a "ID NUMBER FOR MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8733 . This is a "ID NUMBER FOR IMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 28543 . This is a "ID NUMBER FOR SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7195 . This is a "LIC. NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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