Provider Demographics
NPI:1447081492
Name:CAROLINA WOUND & SKIN CARE LLC
Entity type:Organization
Organization Name:CAROLINA WOUND & SKIN CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ CARRASQUILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-752-7897
Mailing Address - Street 1:PO BOX 3762
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3762
Mailing Address - Country:US
Mailing Address - Phone:787-752-7897
Mailing Address - Fax:
Practice Address - Street 1:AVE ROBERTO SANCHEZ VILELLA A-6
Practice Address - Street 2:CASTELLANA GARDENS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-752-7897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty