Healthcare Provider Details

I. General information

NPI: 1508852906
Provider Name (Legal Business Name): EDGARDO R JOGLAR CACHO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 AVE PONCE DE LEON SUITE 326
SAN JUAN PR
00917-3418
US

IV. Provider business mailing address

PO BOX 3948
GUAYNABO PR
00970-3948
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-0086
  • Fax: 787-720-5348
Mailing address:
  • Phone: 787-766-0086
  • Fax: 787-720-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number7074
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: