Provider Demographics
NPI:1427065192
Name:RODRIGUEZ RIVERA, EDGAR ISRAEL (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:ISRAEL
Last Name:RODRIGUEZ RIVERA
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 1:52 CALLE SALVADOR BRAU
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4713
Mailing Address - Country:US
Mailing Address - Phone:787-372-1262
Mailing Address - Fax:
Practice Address - Street 1:52 CALLE SALVADOR BRAU
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4713
Practice Address - Country:US
Practice Address - Phone:787-372-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11329207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR602058OtherMMM
PR1604945OtherACCA
PR6310079OtherHUMANA DE PR
PR3109OtherFIRST MEDICAL
PR3109OtherFIRST MEDICAL