Provider Demographics
NPI:1073578795
Name:MIRANDA-APONTE, EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:MIRANDA-APONTE
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:ME7 AVE LA MARINA
Mailing Address - Street 2:URB MARINA BAHIA
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-6797
Mailing Address - Country:US
Mailing Address - Phone:787-777-3730
Mailing Address - Fax:787-777-3725
Practice Address - Street 1:ME7 AVE LA MARINA
Practice Address - Street 2:URB MARINA BAHIA
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-6797
Practice Address - Country:US
Practice Address - Phone:787-777-3730
Practice Address - Fax:787-777-3725
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6743146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29421Medicare ID - Type UnspecifiedMEDICAR PROVIDER NUMBER