Provider Demographics
NPI:1174526826
Name:ESTRADA, CARLOS J (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:J
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:89 AVE DE DIEGO STE 105
Mailing Address - Street 2:PMB 449
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6370
Mailing Address - Country:US
Mailing Address - Phone:787-403-7898
Mailing Address - Fax:787-403-7898
Practice Address - Street 1:70 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7052
Practice Address - Country:US
Practice Address - Phone:787-403-7898
Practice Address - Fax:787-403-7898
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-25
Last Update Date:2010-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR10539207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology