Healthcare Provider Details

I. General information

NPI: 1992080212
Provider Name (Legal Business Name): EDUARDO RAFAEL SALGUERO-VILLANUEVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA DEL CARMEN MALL #24 CALLE PINO / CARR 172
CAGUAS PR
00725
US

IV. Provider business mailing address

PO BOX 9021257 CENTRO DE ONCOLOGIA INTEGRAL
SAN JUAN PR
00902-1257
US

V. Phone/Fax

Practice location:
  • Phone: 787-286-6060
  • Fax: 787-286-6161
Mailing address:
  • Phone: 787-250-7338
  • Fax: 787-705-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number018335
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: