Provider Demographics
NPI:1053843599
Name:PARTIDA RODRIGUEZ, EDUARDO
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:PARTIDA RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GA13 CALLE PALMA SOLA
Mailing Address - Street 2:GARDEN HILLS SUR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-362-5543
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CASIA VA CARIBBEAN HEALTHCARE SYSTEMS
Practice Address - Street 2:IM RESIDENCY PROGRAM MEDICAL SERVICE 111 OFFICE C-274
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-3670
Practice Address - Fax:787-641-4561
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
PR21309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program