Healthcare Provider Details

I. General information

NPI: 1316883606
Provider Name (Legal Business Name): FIDUS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 CALLE PALMERAS STE 601
SAN JUAN PR
00901-2410
US

IV. Provider business mailing address

53 CALLE PALMERAS STE 601
SAN JUAN PR
00901-2410
US

V. Phone/Fax

Practice location:
  • Phone: 787-674-7352
  • Fax:
Mailing address:
  • Phone: 787-674-7352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RODOLFO ALCEDO
Title or Position: OWNER
Credential: MD
Phone: 787-674-7352