Provider Demographics
NPI:1548303597
Name:GONZALEZ-CARRASQUILLO, FELIX LUIS (MD)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:LUIS
Last Name:GONZALEZ-CARRASQUILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 POTOMAC CROSSING ST
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-1052
Mailing Address - Country:US
Mailing Address - Phone:787-638-1717
Mailing Address - Fax:
Practice Address - Street 1:A-13 2 STREET
Practice Address - Street 2:URB. EL CONVENTO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-804-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12498146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant