Healthcare Provider Details

I. General information

NPI: 1922429984
Provider Name (Legal Business Name): CLINICA CARDIOVASCULAR DE LA MONTANA PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DR. TROYERR A-1 URB. VILLA ROSALES
AIBONITO PR
00705
US

IV. Provider business mailing address

PO BOX 1379
AIBONITO PR
00705-1379
US

V. Phone/Fax

Practice location:
  • Phone: 787-735-5678
  • Fax: 787-735-5678
Mailing address:
  • Phone: 787-735-5678
  • Fax: 787-735-5678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE O GARCIAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-735-5678