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Organization

LUIS E CARRILLO MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LUIS ENRIQUE CARRILLO M.D. (OWNER)
(863) 534-8436
Entity
Organization

Contact information

Practice address
2200 OSPREY BLVD, SUITE 103, BARTOW, FL 33830-3308
(863) 534-8436
(863) 534-8005
Mailing address
PO BOX 7097, LAKELAND, FL 33807-7097
(863) 534-8436
(863) 534-8005

Taxonomy

Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
ME16832
FL

Other

Enumeration date
02/25/2015
Last updated
02/25/2015
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