Provider Demographics
NPI:1053387993
Name:MARCANTONI, EFRAIN A (MD)
Entity type:Individual
Prefix:DR
First Name:EFRAIN
Middle Name:A
Last Name:MARCANTONI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CALLE IGNACIO FERNANDEZ
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-3242
Mailing Address - Country:US
Mailing Address - Phone:787-871-3677
Mailing Address - Fax:787-871-4972
Practice Address - Street 1:12 CALLE IGNACIO FERNANDEZ
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3242
Practice Address - Country:US
Practice Address - Phone:787-871-3677
Practice Address - Fax:787-871-4972
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE08563Medicare UPIN
PR0029032Medicare ID - Type Unspecified