Provider Demographics
NPI:1992764088
Name:FIGUEROA DELGADO, EDWIN O (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:O
Last Name:FIGUEROA DELGADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SERVICIOS
Other - Middle Name:
Other - Last Name:MEDICOS PRIMARIOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:INC
Mailing Address - Street 1:PMB 293 PO BOX 4952
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4952
Mailing Address - Country:US
Mailing Address - Phone:787-704-0250
Mailing Address - Fax:787-286-9691
Practice Address - Street 1:URB PARADISE CALLE CORCHADO B-5
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-704-0250
Practice Address - Fax:787-286-9691
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10013208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82327Medicare ID - Type Unspecified
PRF30914Medicare UPIN