Provider Demographics
NPI:1760740849
Name:RODRIGUEZ-CASTRO, EDDIE MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:MANUEL
Last Name:RODRIGUEZ-CASTRO
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:PALMARES DE MONTEVERDE
Mailing Address - Street 2:94 RAMAL 842 APT 32
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3903
Mailing Address - Country:US
Mailing Address - Phone:787-636-3625
Mailing Address - Fax:
Practice Address - Street 1:BAYAMON MEDICAL PLAZA PR#2 KM11.7
Practice Address - Street 2:SUITE 403
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-602-1243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19102207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine