Provider Demographics
NPI:1427033612
Name:ALBERTY, EDGARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:
Last Name:ALBERTY
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 19446
Mailing Address - Street 2:FERNANDEZ JUNCOS STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910
Mailing Address - Country:US
Mailing Address - Phone:787-725-6297
Mailing Address - Fax:787-724-6490
Practice Address - Street 1:AMERICO SALAS 1452
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-725-6297
Practice Address - Fax:787-724-6490
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4354208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR063852OtherCRUZ AZUL
PR24354OtherMCS
PR25787OtherTRIPLE SSS
PR9120017OtherHUMANA