MEDICARE: DR. LUIS A ALCALDE-PRESEDO D.D.S, M.D.S

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	1223E0200X	Endodontics	DN22522	FL

General Provider Information

NPI Number	:	1528370731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS A ALCALDE-PRESEDO D.D.S, M.D.S

Provider Business Mailing Address
First Line	:	820 STATE RD, 434 N., SUITE B
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714
Country	:	US
Telephone Number	:	407-278-1210
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 N STATE ROAD 434 STE B
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-7036
Country	:	US
Telephone Number	:	407-278-1210
Fax Number	:

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

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	07/21/2022

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