Basic Information
| Provider Information | |||||||||
| NPI: | 1548244155 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARRION-VARGAS | ||||||||
| FirstName: | ENRIQUE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 216 CALLE METIS | ||||||||
| Address2: | PASEO DEL SOL | ||||||||
| City: | DORADO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006464619 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | HOSPITAL PEDIATRICO UNIVERSITARIO | ||||||||
| Address2: | DEPARTAMENTO DE PEDIATRIA | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 03/21/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 12204 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | 12204 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080P0203X | 12204 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.