Provider Demographics
NPI:1669459699
Name:RODRIGUEZ RAMOS, EDWIN SR (MD)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:RODRIGUEZ RAMOS
Suffix:SR
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:PO BOX 1374
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1374
Mailing Address - Country:US
Mailing Address - Phone:787-734-5560
Mailing Address - Fax:787-734-4077
Practice Address - Street 1:CALLE BALDORIOTY 6 ESQ DANIEL FLORES
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-1374
Practice Address - Country:US
Practice Address - Phone:787-734-5560
Practice Address - Fax:787-734-4077
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11941208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
G42507Medicare UPIN
PR0088483Medicare ID - Type Unspecified