Healthcare Provider Details

I. General information

NPI: 1639916729
Provider Name (Legal Business Name): DR. JOEL SANTIAGO VALCARCEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO OFFICE PARK IV, BUILDING STREET ROAD, #201,5 CARR PUERTO RICO 2 KM 156
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

HC 02 BOX 6720
HORMIGUEROS PR
00660
US

V. Phone/Fax

Practice location:
  • Phone: 787-986-5050
  • Fax:
Mailing address:
  • Phone: 787-234-0549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number862-PA
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: