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NPI Code Detail

MEDICARE: RENATO R ALCALDE MD

MEDICARE:   RENATO R ALCALDE  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianME30161FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2605640700OTHERACS
3ME30161OTHERFLPROFESSIONAL LICENSE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033174495
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENATO R ALCALDE MD
Provider Business Mailing Address
First Line : P.O. BOX 19249
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32245-9249
Country : US
Telephone Number : 904-743-1883
Fax Number : 904-695-2465
Provider Business Practice Location Address
First Line : 3333 W 20TH ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32254-1703
Country : US
Telephone Number : 904-695-9145
Fax Number : 904-695-2465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 02/26/2019

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Directions to “ RENATO R ALCALDE MD” Practice Location

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