1215097258 NPI number — MR. EDWIN COIMBRE CARTAGONA SR. MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215097258 NPI number — MR. EDWIN COIMBRE CARTAGONA SR. MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

COIMBRE CARTAGONA

Provider First Name:

EDWIN

Provider Middle Name:

Provider Name Prefix Text:

MR.

Provider Name Suffix Text:

SR.

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1215097258

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/15/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

P O BOX 1865, COAMO PUERTO RICO 00769

Provider Second Line Business Mailing Address:

CALLE JOSE I QUINTON, COAMO PUERTO RICO 00769

Provider Business Mailing Address City Name:

COAMO

Provider Business Mailing Address State Name:

PUERTO RICO

Provider Business Mailing Address Postal Code:

00769

Provider Business Mailing Address Country Code:

UM

Provider Business Mailing Address Telephone Number:

787-825-0643

Provider Business Mailing Address Fax Number:

787-825-2352

Provider First Line Business Practice Location Address:

65 CALLE JOSE I QUINTON # 769

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

COAMO

Provider Business Practice Location Address State Name:

PR

Provider Business Practice Location Address Postal Code:

00769-3105

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

787-825-0643

Provider Business Practice Location Address Fax Number:

787-825-2352

Provider Enumeration Date:

12/11/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  8370 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 3400 . This is a "PMC" identifier . This identifiers is of the category "OTHER".
• Identifier: PIN P00087211 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
• Identifier: 38675 . This is a "PROSSAM" identifier . This identifiers is of the category "OTHER".
• Identifier: 660402309 . This is a "MAPFRE EXCEL" identifier . This identifiers is of the category "OTHER".
• Identifier: 660610705 . This is a "MAPFRE" identifier . This identifiers is of the category "OTHER".
• Identifier: 7570009 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0985 . This is a "FIRST PLUS" identifier . This identifiers is of the category "OTHER".
• Identifier: 1553 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 0985 . This is a "FIRST MEDICAL INC" identifier . This identifiers is of the category "OTHER".
• Identifier: 4361070 . This is a "UIA" identifier . This identifiers is of the category "OTHER".
• Identifier: 1109286 . This is a "ACAA" identifier . This identifiers is of the category "OTHER".
• Identifier: 660610705 . This is a "MEDICARE Y MUCHO MAS" identifier . This identifiers is of the category "OTHER".
• Identifier: 660610705 . This is a "COSVIMEDCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0081807 . This is a "TRIPLE S INC" identifier . This identifiers is of the category "OTHER".