Provider Demographics
NPI:1922620160
Name:CALCANO-PEREZ, JULIO ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:ANTONIO
Last Name:CALCANO-PEREZ
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 399
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0399
Mailing Address - Country:US
Mailing Address - Phone:787-789-8280
Mailing Address - Fax:
Practice Address - Street 1:CARR #1 KM 23.7
Practice Address - Street 2:BARRIO RIO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00965
Practice Address - Country:US
Practice Address - Phone:787-789-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23569208D00000X
PR000532-PA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice