Healthcare Provider Details

I. General information

NPI: 1427117134
Provider Name (Legal Business Name): CRESPO BROTHERS CARDIOVASCULAR CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONSERRATE AB-17 AVE. VALLE ARRIBA HEIGHTS
CAROLINA PR
00985
US

IV. Provider business mailing address

AVE. MONSERRATE AB-17 VALLE ARRIBA HEIGHTS
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-217-1886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL CRESPO
Title or Position: PRESIDENT
Credential:
Phone: 787-217-1886