Provider Demographics
NPI:1548235153
Name:FIGUEROA-GONZALEZ, EDGAR A (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:A
Last Name:FIGUEROA-GONZALEZ
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 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-8078
Mailing Address - Fax:
Practice Address - Street 1:1425 MALABAR RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2506
Practice Address - Country:US
Practice Address - Phone:321-434-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55856208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRH857OtherMEDICARE HF
FL370849700Medicaid
FL020049513OtherRAILROAD MEDICARE
FL3708497-00Medicaid
FL11911YMedicare PIN
FL11911XMedicare PIN