MEDICARE: DR. RODOLFO ELIAS ALCEDO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	88E	PR

General Provider Information

NPI Number	:	1316141534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODOLFO ELIAS ALCEDO M.D.

Provider Business Mailing Address
First Line	:	75 FRANCIS STREET
Second Line	:	NEUROLOGICAL SURGERY RESIDENCY TRAINING PROGRAM
City	:	BOSTON
State	:	MA
Zip	:	02115
Country	:	US
Telephone Number	:	617-732-8719
Fax Number	:

Provider Business Practice Location Address
First Line	:	CAMELOT CONDOMINIUM NUMBER 140 STREET 842
Second Line	:	APARTMENT 3103
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	09/30/2016

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