Provider Demographics
NPI:1609970920
Name:ALCANTARA CARDI, GEORGE D (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:D
Last Name:ALCANTARA CARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 140401
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0401
Mailing Address - Country:US
Mailing Address - Phone:787-817-3392
Mailing Address - Fax:787-817-1501
Practice Address - Street 1:AVE. JOSE CELSO BARBOSA #65
Practice Address - Street 2:ARECIBO MEDICAL PLAZA SUITE 201
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-817-3392
Practice Address - Fax:787-817-1501
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10873208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83690Medicare PIN