Healthcare Provider Details

I. General information

NPI: 1629073531
Provider Name (Legal Business Name): JULIO A CALCANO-PEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 04/13/2024
Certification Date: 04/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 1 KM 23.7 BARRIO RIO
GUAYNABO PR
00965
US

IV. Provider business mailing address

HC 1 BOX 29030 PMB 119
CAGUAS PR
00725-8900
US

V. Phone/Fax

Practice location:
  • Phone: 787-731-1515
  • Fax: 787-731-6267
Mailing address:
  • Phone: 787-731-1515
  • Fax: 787-731-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number3842
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number3842
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number3842
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: