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General NPI Number Information
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NPI Number | 1649639022
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Entity Type | Individual
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Provider Name | EDUARDO J MEDINA PARRILLA MD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 300C CALLE MANUEL DOMENECH
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City | SAN JUAN
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State | PR
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Zip | 00918-3509
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Country | US
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Telephone | 352-709-2828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 367501
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 19628
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207ZN0500X
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Taxonomy Name | Neuropathology Physician
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License Number | 19628
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License Number State | PR
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