Provider Demographics
NPI:1578530929
Name:APONTE, EDGARDO R (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:R
Last Name:APONTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CALLE BARCELO
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1605
Mailing Address - Country:US
Mailing Address - Phone:787-857-1987
Mailing Address - Fax:787-857-1987
Practice Address - Street 1:103 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1605
Practice Address - Country:US
Practice Address - Phone:787-857-1987
Practice Address - Fax:787-857-1987
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10723208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF47606Medicare UPIN