Healthcare Provider Details

I. General information

NPI: 1750388542
Provider Name (Legal Business Name): JOSE A CANCIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL EMPORIUM II SUITE 1A 349 HOSTOS AVENUE
MAYAGUEZ PR
00682
US

IV. Provider business mailing address

PO BOX 1430
HORMIGUEROS PR
00660-5430
US

V. Phone/Fax

Practice location:
  • Phone: 787-806-2600
  • Fax: 787-806-2656
Mailing address:
  • Phone: 787-806-2600
  • Fax: 787-806-2656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number13997
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: