1730150244 NPI number — DR. EDGARDO FIGUEROA-MUNIZ MD

Table of content: DR. EDGARDO FIGUEROA-MUNIZ MD (NPI 1730150244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730150244 NPI number — DR. EDGARDO FIGUEROA-MUNIZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIGUEROA-MUNIZ
Provider First Name:
EDGARDO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1730150244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7479
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-840-6838
Provider Business Mailing Address Fax Number:
787-842-6838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
606 AVE. TITO CASTRO
Provider Second Line Business Practice Location Address:
SUITE 233 LA RAMBLA PLAZA
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-6838
Provider Business Practice Location Address Fax Number:
787-842-6838
Provider Enumeration Date:
02/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  16058 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)