Provider Demographics
NPI:1750379830
Name:VARGAS, CARLOS TULIO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:TULIO
Last Name:VARGAS
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:PO BOX 832
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0832
Mailing Address - Country:US
Mailing Address - Phone:787-948-0400
Mailing Address - Fax:
Practice Address - Street 1:A2 CALLE DR TROYER
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3304
Practice Address - Country:US
Practice Address - Phone:787-948-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR81092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C82727Medicare UPIN
DD6477Medicare ID - Type Unspecified