Provider Demographics
NPI:1770538969
Name:RODRIGUEZ ALLENDE, EDWIN F (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:F
Last Name:RODRIGUEZ ALLENDE
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 1450
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1450
Mailing Address - Country:US
Mailing Address - Phone:787-735-1830
Mailing Address - Fax:
Practice Address - Street 1:CALLE DOMINGO CINTRON EDIFICIO GUAYACAN 107
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-1830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF77133Medicare UPIN