Most Relevant Information
Provider Data
| NPI Number: | 1003317934 |
| Provider Name: | CARLOS MANUEL CAMPA MALDONADO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 6177799 |
Most Important Dates
| Enumeration Date: | 02/26/2018 |
| Last Updated: | 02/26/2018 |
Provider Practice Location
761 LOS CAMPOS DE MONTEHIEDRA
SAN JUAN
PR
00926
Practice Location Phone/Fax
| Phone: | 7872185876 |
| Fax: |
Provider Mailing Location
761 LOS CAMPOS DE MONTEHIEDRA
SAN JUAN
PR
00926
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |