Healthcare Provider Details

I. General information

NPI: 1750366969
Provider Name (Legal Business Name): XAVIER CALES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5259 CALLE CARACAS
PONCE PR
00717-1762
US

IV. Provider business mailing address

CALLE 12, H-11 JARDINES FAGOT
PONCE PR
00716-4070
US

V. Phone/Fax

Practice location:
  • Phone: 787-842-1496
  • Fax: 787-842-1496
Mailing address:
  • Phone: 787-844-7708
  • Fax: 787-842-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number8573
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: