Healthcare Provider Details
I. General information
NPI: 1518872498
Provider Name (Legal Business Name): AEDES MEDICAL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 CALLE DR BASORA N
MAYAGUEZ PR
00680-4833
US
IV. Provider business mailing address
PO BOX 286
ISABELA PR
00662-0286
US
V. Phone/Fax
- Phone: 787-431-3589
- Fax:
- Phone: 787-431-3589
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DIEGO
M
CANABAL-LOPEZ
Title or Position: INFECTIOUS DISEASE PHYSICIAN
Credential: MD
Phone: 787-431-3589