Provider Demographics
NPI:1033262555
Name:CARTAGENA AYALA, EDGARDO F (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:F
Last Name:CARTAGENA AYALA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:600 BOULEVARD ARBOLES 401
Mailing Address - Street 2:ARBOLES DE MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-767-6777
Mailing Address - Fax:787-767-6878
Practice Address - Street 1:369 AVE DE DIEGO
Practice Address - Street 2:SUITE 308 TORRE SAN FRANCISCO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-0000
Practice Address - Country:US
Practice Address - Phone:787-767-6777
Practice Address - Fax:787-767-6878
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9546207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41612Medicare UPIN