Individual
MR. RAUL TADEO CARRILLO-BISLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1970 HOSPITAL VIEW WAY STE 2, CLERMONT, FL 34711
(352) 404-8072
(352) 404-8312
Mailing address
1970 HOSPITAL VIEW WAY STE 2, CLERMONT, FL 34711-1926
(352) 404-8072
(352) 404-8312
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME87534
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253650100
—
FL
05
—
267028300
—
FL
01
—
78798
BLUE SHIELD
FL
Enumeration date
08/18/2005
Last updated
07/21/2022
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