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General NPI Number Information
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NPI Number | 1205032034
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Entity Type | Individual
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Provider Name | CALEB E. FELICIANO - VALLS MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | CLINICA DE LA ESCUELA DE MEDICINA REPARTO METROPOLITANO SHOPPING , AVE. AMERICO MIRANDA
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City | RIO PIEDRAS
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State | PR
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Zip | 00921-0000
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Country | US
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Telephone | 787-474-2947
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Fax | 787-625-1965
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Provider Business Mailing Address
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Address Line | NEUROCIRUGIA ENDOVASCULAR RCM PO BOX 29134
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City | SAN JUAN
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State | PR
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Zip | 00929-0134
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Country | US
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Telephone | 787-765-8276
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Fax | 787-753-3492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 14227
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 14227
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License Number State | PR
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