Edgardo J Rivera Escobar, MD
General Practice in San Juan, PR. Individual provider (NPI-1).
NPI number1164065371
StatusActive
Last updated in NPPESSep 6, 2022
Details
- NPI
- 1164065371
- Entity type
- Individual (NPI-1)
- Name
- Edgardo J Rivera Escobar
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2019
- Certification date
- Sep 6, 2022
- Last updated
- Sep 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 22979 | PR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | PR |
Practice location
10 Calle CasiaSan Juan, PR 00921-3200
Phone 787-641-7582
Mailing address
B9 Calle BenitezGuaynabo, PR 00969-3437
Phone 787-209-5939
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