Provider Demographics
NPI:1972826386
Name:TORO NIEVES, EDISON JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:EDISON
Middle Name:JAVIER
Last Name:TORO NIEVES
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 446
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0446
Mailing Address - Country:US
Mailing Address - Phone:939-252-2846
Mailing Address - Fax:
Practice Address - Street 1:8A CALLE EDUARDO QUEVEDO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2617
Practice Address - Country:US
Practice Address - Phone:939-252-2846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17836208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice