Provider Demographics
NPI:1194788000
Name:CANALS, RICARDO M (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:M
Last Name:CANALS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360097
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0097
Mailing Address - Country:US
Mailing Address - Phone:787-774-0692
Mailing Address - Fax:787-706-9112
Practice Address - Street 1:3S3 CALLE 21
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7335
Practice Address - Country:US
Practice Address - Phone:787-774-0692
Practice Address - Fax:787-706-9112
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12118207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG30940Medicare UPIN
PR88514Medicare ID - Type Unspecified