Provider Demographics
NPI:1508021742
Name:FALCAO, GERMANO (MD)
Entity Type:Individual
Prefix:
First Name:GERMANO
Middle Name:
Last Name:FALCAO
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 1:2984 ALAFAYA TRL
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7628
Mailing Address - Country:US
Mailing Address - Phone:407-278-2401
Mailing Address - Fax:407-278-2402
Practice Address - Street 1:2984 ALAFAYA TRL STE 2020
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7628
Practice Address - Country:US
Practice Address - Phone:407-278-2401
Practice Address - Fax:407-278-2402
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1258082084P0804X, 2084N0402X, 2084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015902200Medicaid
FLME125808OtherFLORIDA MEDICAL LICENSE