Healthcare Provider Details

I. General information

NPI: 1053387993
Provider Name (Legal Business Name): EFRAIN A. MARCANTONI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CALLE IGNACIO FERNANDEZ
CIALES PR
00638-3242
US

IV. Provider business mailing address

12 CALLE IGNACIO FERNANDEZ
CIALES PR
00638-3242
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-3677
  • Fax: 787-871-4972
Mailing address:
  • Phone: 787-871-3677
  • Fax: 787-871-4972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7712
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: