Physician Compare National (NPI:1366440364)

HEALTHCARE PROVIDER: EDGAR AUGUSTO CARDONA-TRAVERZO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1366440364
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840470530
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110214000104
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CARDONA TRAVERZO
	Individual professional last name
Provider First Name	EDGAR
	Individual professional first name
Provider Middle Name	AUGUSTO
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	RYDER MEDICAL AND PROFESSIONAL BLDG
	Group Practice or individual's line 1 address
Line 2 Street Address	355 AVE FONT MARTELO SUITE 213 HOSPITAL RYDER
	Group Practice or individual's line 2 address
City	HUMACAO
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	007913249
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7876389705
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y