Provider Demographics
NPI:1609389980
Name:FALCO, GIANCARLO ANTONIO (RNP)
Entity Type:Individual
Prefix:MR
First Name:GIANCARLO
Middle Name:ANTONIO
Last Name:FALCO
Suffix:
Gender:M
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 TURNBERRY WAY APT 21G
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2505
Mailing Address - Country:US
Mailing Address - Phone:786-302-6355
Mailing Address - Fax:
Practice Address - Street 1:20900 NE 30TH AVE STE 849
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2157
Practice Address - Country:US
Practice Address - Phone:786-553-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9346080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily