Provider Demographics
NPI:1770169641
Name:CANCIO-AMADEO, DANIEL ENRIQUE
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ENRIQUE
Last Name:CANCIO-AMADEO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KM 8.3 CALLE 3, AV. 65 DE INFANTERIA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984
Mailing Address - Country:US
Mailing Address - Phone:787-757-1800
Mailing Address - Fax:
Practice Address - Street 1:PASEO DR. JOSE CELSO BARBOSA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16769390200000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program