Provider Demographics
NPI:1649343369
Name:ALEJANDRO, EDWIN (MD)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYAMON MEDICAL PLAZA
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-785-8666
Mailing Address - Fax:787-798-5700
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 106
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-8666
Practice Address - Fax:787-798-5700
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10244207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
82471Medicare ID - Type Unspecified
E91104Medicare UPIN