Healthcare Provider Details

I. General information

NPI: 1336282029
Provider Name (Legal Business Name): CAGUAS CARDIO IMAGING GROUP, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARIBBEAN CINEMAS BUILDINGS LAS CATALINAS SHOPPING CENTER OFICINA # 208
CAGUAS PR
00725-3757
US

IV. Provider business mailing address

PMB 482 AVE 200 RAFAEL CORDERO SUITE 140
CAGUAS PR
00725-3757
US

V. Phone/Fax

Practice location:
  • Phone: 787-747-6045
  • Fax: 787-258-6551
Mailing address:
  • Phone: 787-747-6045
  • Fax: 787-258-6551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JESUS M SANTOS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-747-6045