Provider Demographics
NPI:1912022732
Name:CAUSSADE, EDUARDO I (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:I
Last Name:CAUSSADE
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 1:1007 AVE MUNOZ RIVERA
Mailing Address - Street 2:COND DARLINGTON SUITE 1110
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2717
Mailing Address - Country:US
Mailing Address - Phone:787-764-1506
Mailing Address - Fax:
Practice Address - Street 1:1007 AVE MUNOZ RIVERA
Practice Address - Street 2:COND DARLINGTON SUITE 1110
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925-2717
Practice Address - Country:US
Practice Address - Phone:787-764-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR79882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7988OtherSTATE LICENSE