NPIMap

Organization Active NPI

Renato R Alcalde MD Abpn LLC

  • Psychiatry Physician
  • Port St Lucie, FL
National Provider Identifier
1902986573
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME30161 Issued in FL
Legal business name
RENATO R ALCALDE MD ABPN LLC
Practice address
1881 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone
(772) 398-3237
Fax
(772) 335-4734
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renato R Alcalde, MD
Title
Manager Owner
Phone
(772) 398-3237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X ME30161 FL Primary

Addresses

Primary practice location

1881 SE Port St Lucie Blvd
Port St Lucie, FL 34952

Mailing address

PO Box 880746
Port St Lucie, FL 34988
Phone (772) 398-3237

Other identifiers 1

IdentifierTypeStateIssuer
P00218464OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1902986573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880746",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34988",
            "telephone_number": "772-398-3237",
            "fax_number": "772-335-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-398-3237",
            "fax_number": "772-335-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENATO R ALCALDE MD ABPN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "ALCALDE",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER OWNER",
        "authorized_official_telephone_number": "772-398-3237",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME30161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00218464",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.