Healthcare Provider Details

I. General information

NPI: 1285181164
Provider Name (Legal Business Name): CARIBBEAN HEART INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LUIS MUNOZ MARIN STE 305
CAGUAS PR
00725-6184
US

IV. Provider business mailing address

PO BOX 191855
SAN JUAN PR
00919-1855
US

V. Phone/Fax

Practice location:
  • Phone: 787-920-4090
  • Fax:
Mailing address:
  • Phone: 787-633-4263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number17995
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number17995
License Number StatePR

VIII. Authorized Official

Name: LUIS A JIMENEZ REYES
Title or Position: PRESIDENT
Credential:
Phone: 787-633-4263