Provider Demographics
NPI:1598886202
Name:RODRIGUEZ VAZQUEZ, EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:RODRIGUEZ VAZQUEZ
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 1:68 CALLE SANTA CRUZ
Mailing Address - Street 2:TORRE MEDICA SAN PABLO SUITE 901
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7031
Mailing Address - Country:US
Mailing Address - Phone:787-740-0713
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:68 CALLE SANTA CRUZ
Practice Address - Street 2:TORRE MEDICA SAN PABLO SUITE 901
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7031
Practice Address - Country:US
Practice Address - Phone:787-740-0713
Practice Address - Fax:787-740-0713
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87482086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0029851OtherMEDICARE PTAN
PR0029851OtherMEDICARE PTAN