Individual
TATIANA CARRASQUILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2601 DAUPHIN ISLAND PKWY, MOBILE, AL 36605-3472
(251) 445-3450
Mailing address
2601 DAUPHIN ISLAND PKWY, MOBILE, AL 36605-3472
(251) 445-3459
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43960
AL
208D00000X
General Practice Physician
125.073796
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/18/2015
Last updated
08/30/2022
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