Provider Demographics
NPI:1366696411
Name:MACIAS, KARLA (M D)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MIGUEL POU 1550
Mailing Address - Street 2:APT. 2301 PASEO DEL REY
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-543-3061
Mailing Address - Fax:
Practice Address - Street 1:MIGUEL POU 1550
Practice Address - Street 2:APT. 2301 PASEO DEL REY
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-543-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27,222-R208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice