Provider Demographics
NPI:1558336727
Name:PIAZZA, EDWIN LUGO (MD)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:LUGO
Last Name:PIAZZA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:EDIF MEDICO SANTA CRUZ
Mailing Address - Street 2:OFICINA 316
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6910
Mailing Address - Country:US
Mailing Address - Phone:787-787-8788
Mailing Address - Fax:787-787-4900
Practice Address - Street 1:EDIF MEDICO SANTA CRUZ
Practice Address - Street 2:OFICINA 316
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-787-8788
Practice Address - Fax:787-787-4900
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR4123207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR24690OtherTRIPLE-S
PRC77252Medicare UPIN