Healthcare Provider Details

I. General information

NPI: 1073259925
Provider Name (Legal Business Name): CARIBBEAN HEART AND IMAGE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #1 VILLA BLANCA INDUSTRIAL PARK SUITE 115, PLAZA BAIROA
CAGUAS PR
00725
US

IV. Provider business mailing address

PO BOX 191855
SAN JUAN PR
00919-1855
US

V. Phone/Fax

Practice location:
  • Phone: 939-715-0050
  • Fax: 877-736-2593
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS ALBERTO JIMENEZ REYES
Title or Position: ELECTROPHYSIOLOGIST
Credential: MD
Phone: 787-633-4263