Provider Demographics
NPI:1275522591
Name:ALCARAZ, VICENTE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICENTE
Middle Name:
Last Name:ALCARAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191168
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1168
Mailing Address - Country:US
Mailing Address - Phone:787-758-2404
Mailing Address - Fax:787-764-4222
Practice Address - Street 1:572 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3738
Practice Address - Country:US
Practice Address - Phone:787-758-2404
Practice Address - Fax:787-764-4827
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6117207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
27538ALOtherTRIPLE S REFORMA
27538ALOtherTRIPLE S
27538ALOtherMCOPTIMO
0800133OtherHUMANA
825145OtherMEDICARE Y MUCHO MAS
065931OtherCRUZ AZUL
D08425Medicare UPIN
27538ALOtherMCOPTIMO