Provider Demographics
NPI:1952314254
Name:BERMUDEZ, ARIEL EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:EDUARDO
Last Name:BERMUDEZ
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:PO BOX 364926
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4926
Mailing Address - Country:US
Mailing Address - Phone:787-786-6309
Mailing Address - Fax:787-798-1004
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:CARR NUM 2 SUITE 809
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-786-6309
Practice Address - Fax:787-798-1004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10950208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery