MEDICARE: DR. CALEB E. FELICIANO - VALLS 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
1	2085R0204X	Vascular & Interventional Radiology Physician	14227	PR
2	207T00000X	Neurological Surgery Physician	14227	PR

General Provider Information

NPI Number	:	1205032034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CALEB E. FELICIANO - VALLS MD

Provider Business Mailing Address
First Line	:	NEUROCIRUGIA ENDOVASCULAR RCM
Second Line	:	PO BOX 29134
City	:	SAN JUAN
State	:	PR
Zip	:	00929-0134
Country	:	US
Telephone Number	:	787-765-8276
Fax Number	:	787-753-3492

Provider Business Practice Location Address
First Line	:	CLINICA DE LA ESCUELA DE MEDICINA
Second Line	:	REPARTO METROPOLITANO SHOPPING , AVE. AMERICO MIRANDA
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00921-0000
Country	:	US
Telephone Number	:	787-474-2947
Fax Number	:	787-625-1965

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	02/01/2024

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