Provider Demographics
NPI:1700173762
Name:REYES APONTE, EDGARDO JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:JAVIER
Last Name:REYES APONTE
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 191808
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1808
Mailing Address - Country:US
Mailing Address - Phone:787-474-9870
Mailing Address - Fax:
Practice Address - Street 1:576 CALLE CESAR GONZALEZ STE 406
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3758
Practice Address - Country:US
Practice Address - Phone:787-474-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19132207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine