MEDICARE: DR. RAUL ANTONIO SALCEDO D.P.M

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	213ES0131X	Foot Surgery Podiatrist	40	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA48056	OTHER	PR	HEALTH INSURANCE
2	0048056	OTHER	PR	MCA
3	073019	OTHER	PR	HEALTL INSURANCE
4	9590047	OTHER	PR	HEALTH INSURANCE

General Provider Information

NPI Number	:	1760487748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL ANTONIO SALCEDO D.P.M

Provider Business Mailing Address
First Line	:	PO BOX 764
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-0764
Country	:	US
Telephone Number	:	787-667-0058
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB HERMANAS DAVILA CALLE J EDIFICIO HERMANAS DAVILA
Second Line	:	OFIC 205
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-667-0058
Fax Number	:

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	12/31/2024

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Directions to “ DR. RAUL ANTONIO SALCEDO D.P.M” Practice Location

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