Provider Demographics
NPI:1679682603
Name:ALCARAZ, LUIS GERARDO (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:GERARDO
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 99
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0099
Mailing Address - Country:US
Mailing Address - Phone:787-882-4322
Mailing Address - Fax:
Practice Address - Street 1:23 BETANCES
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5052
Practice Address - Country:US
Practice Address - Phone:787-882-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10216207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82975Medicare UPIN
PR0780650001Medicare NSC
PRF41056Medicare UPIN