Healthcare Provider Details

I. General information

NPI: 1124950092
Provider Name (Legal Business Name): CARDIONOVA,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CARR 696
DORADO PR
00646-5718
US

IV. Provider business mailing address

PO BOX 140912
ARECIBO PR
00614-0912
US

V. Phone/Fax

Practice location:
  • Phone: 787-665-2222
  • Fax:
Mailing address:
  • Phone: 787-239-4241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUELY J ROMAN LOPEZ
Title or Position: PRESIDENTA
Credential: MD
Phone: 787-239-4241