Organization
RENATO R ALCALDE MD ABPN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATO R ALCALDE MD (MANAGER OWNER)
(772) 398-3237
Entity
Organization
Contact information
Practice address
1881 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952
(772) 398-3237
(772) 335-4734
Mailing address
PO BOX 880746, PORT ST LUCIE, FL 34988
(772) 398-3237
(772) 335-4734
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME30161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00218464
RAILROAD MEDICARE
FL
Enumeration date
10/17/2006
Last updated
09/17/2007
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