Provider Demographics
NPI:1942419130
Name:RODRIGUEZ, EDDA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:EDDA
Middle Name:LUZ
Last Name:RODRIGUEZ
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PRIVATE MAIL BOX 410
Mailing Address - Street 2:POBOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-447-8575
Mailing Address - Fax:787-781-3736
Practice Address - Street 1:1051E LA RIVIERA
Practice Address - Street 2:COND. MEDICAL CENTER PLAZA 310
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-447-8575
Practice Address - Fax:787-781-3736
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR103552083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10355OtherLICENSE