Provider Demographics
NPI:1548442262
Name:CARRO-RIVERA, JOSE ANTONIO (MD FAAPMR)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:CARRO-RIVERA
Suffix:
Gender:M
Credentials:MD FAAPMR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 AVE PONCE DE LEON
Mailing Address - Street 2:STE 608
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1811
Mailing Address - Country:US
Mailing Address - Phone:787-777-1017
Mailing Address - Fax:787-777-1018
Practice Address - Street 1:1605 AVE PONCE DE LEON
Practice Address - Street 2:STE 608
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-1811
Practice Address - Country:US
Practice Address - Phone:787-777-1017
Practice Address - Fax:787-777-1018
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17463208100000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice