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General NPI Number Information
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NPI Number | 1710937891
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Entity Type | Individual
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Provider Name | EDGAR A. NEVAREZ-SOSTRE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | CARRETERA #2 KM. 4 HCT. 40 EDIFICIO 4060 SUITE # 6
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-240-1809
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Fax | 787-796-7313
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Provider Business Mailing Address
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Address Line | CALLE 9 # B-4 URB. JARDINES DE DORADO
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-240-1809
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Fax | 787-796-7313
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 12124
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License Number State | PR
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