Provider Demographics
NPI:1336218700
Name:MORA PINERO, EDNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:EDNA
Middle Name:M
Last Name:MORA PINERO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:261 CALLE DUKE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4120
Mailing Address - Country:US
Mailing Address - Phone:787-274-1908
Mailing Address - Fax:787-274-1908
Practice Address - Street 1:261 CALLE DUKE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4120
Practice Address - Country:US
Practice Address - Phone:787-766-1240
Practice Address - Fax:787-758-8304
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR93242086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9324OtherSTATE LICENSE
PRF62314Medicare UPIN
PR8-1515Medicare PIN