Provider Demographics
NPI:1629093810
Name:CORDERO-RIOS, EFRAIN (MD PHD)
Entity Type:Individual
Prefix:
First Name:EFRAIN
Middle Name:
Last Name:CORDERO-RIOS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 AVE ISLA VERDE
Mailing Address - Street 2:COND LOS PINOS 3-C, TORRE ESTE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-7166
Mailing Address - Country:US
Mailing Address - Phone:787-791-5818
Mailing Address - Fax:
Practice Address - Street 1:10 CASIA STREET
Practice Address - Street 2:VA CARIBBEAN HEALTHCARE SYSTEM, AMBULATORY CARE SVC
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3201
Practice Address - Country:US
Practice Address - Phone:787-758-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine