Active NPI
Edjean M Calderon, MSPT
- Physical Therapist
- Guaynabo, PR
National Provider Identifier
1548601040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1390
- Practice address
- 100 Carr 165
Torre 1 Siute 303
Guaynabo, PR 00968-8047 - Phone
- (757) 277-0847
- Fax
- (787) 277-0942
- NPI assigned
- Jul 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1390 | PR | Primary |
Addresses
Primary practice location
100 Carr 165
Torre 1 Siute 303
Guaynabo, PR 00968-8047
Mailing address
PO Box 363024
San Juan, PR 00936-3024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1390 | PR | MD | General Practice Dentistry |
| 1380 | PR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1548601040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 363024",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009363024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CARR 165",
"address_2": "TORRE 1 SIUTE 303",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "009688047",
"telephone_number": "757-277-0847",
"fax_number": "787-277-0942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "EDJEAN",
"middle_name": "M",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-12",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PR",
"license": "1390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guaynabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.