Active NPI
Edda Luz Rodriguez, MD
- Public Health & General Preventive Medicine Physician
- Rio Piedras, PR
National Provider Identifier
1942419130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 10355
- Practice address
- 1051E la Riviera
Cond. Medical Center Plaza 310
Rio Piedras, PR 00921 - Phone
- (787) 447-8575
- Fax
- (787) 781-3736
- NPI assigned
- May 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 10355 | PR | Primary |
Addresses
Primary practice location
1051E la Riviera
Cond. Medical Center Plaza 310
Rio Piedras, PR 00921
Mailing address
Private Mail Box 410
Pobox 70344
San Juan, PR 00936-8344
Phone (787) 447-8575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10355 | Other | PR | LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10355 | PR | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942419130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PRIVATE MAIL BOX 410",
"address_2": "POBOX 70344",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009368344",
"telephone_number": "787-447-8575",
"fax_number": "787-781-3736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051E LA RIVIERA",
"address_2": "COND. MEDICAL CENTER PLAZA 310",
"city": "RIO PIEDRAS",
"state": "PR",
"postal_code": "00921",
"telephone_number": "787-447-8575",
"fax_number": "787-781-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "EDDA",
"middle_name": "LUZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "PR",
"license": "10355",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "10355",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rio Piedras, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.