Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 8748 | PR |
NPI | 1598886202 |
---|---|
Provider Name | Dr. Eduardo Rodriguez Vazquez |
First Address | Bayamon, PR 00961-7031 |
Second Address | Bayamon, PR 00961-7031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 14/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0029851 | MEDICARE PTAN (01) | PR |