Healthcare Provider Details

I. General information

NPI: 1730006214
Provider Name (Legal Business Name): IGOR TOLENTINO NARCISO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 DEL PRADO BLVD
CAPE CORAL FL
33990-5616
US

IV. Provider business mailing address

452 PENLEY LAKE CIR UNIT 306
CAPE CORAL FL
33991-1655
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-3161
  • Fax:
Mailing address:
  • Phone: 239-424-3161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN46499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: