Provider Demographics
NPI:1164466850
Name:FEBO SALGADO, EDGARDO L (MD)
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:L
Last Name:FEBO SALGADO
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:PMB 172 PO BOX 4960
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-643-6393
Mailing Address - Fax:787-286-6299
Practice Address - Street 1:CALLE SANTIAGO BAJOS
Practice Address - Street 2:# 55
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2438
Practice Address - Country:US
Practice Address - Phone:787-286-6299
Practice Address - Fax:787-286-6299
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8938208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF47575Medicare UPIN
PREL585AMedicare PIN