Provider Demographics
NPI:1023008612
Name:PEREZ RODRIGUEZ, EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801117
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1117
Mailing Address - Country:US
Mailing Address - Phone:787-841-7030
Mailing Address - Fax:787-844-1125
Practice Address - Street 1:2225 EDIFICIO PARRA SUITE 802
Practice Address - Street 2:PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-841-7030
Practice Address - Fax:787-844-1125
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9128207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF43663Medicare UPIN
PR83187Medicare ID - Type Unspecified