Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 9128 | PR |
NPI | 1023008612 |
---|---|
Provider Name | Dr. Eduardo Perez Rodriguez |
First Address | Coto Laurel, PR 00780-1117 |
Second Address | Ponce, PR 00717-1322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 19/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F43663 | (02) | PR |