Provider Demographics
NPI:1285203349
Name:PICART, ANGEL ANTONIO
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:ANTONIO
Last Name:PICART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA ROSA 1 B 4 AVE LOS VETERANOS
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-864-9810
Mailing Address - Fax:787-866-8925
Practice Address - Street 1:71 BDA LAS MERCEDES
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2097
Practice Address - Country:US
Practice Address - Phone:939-335-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022516208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice