Healthcare Provider Details

I. General information

NPI: 1902505936
Provider Name (Legal Business Name): MANATI CARDIOVASCULAR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALLE JOSE D CANDELAS STE 107 MANATI MEDICAL PLAZA
MANATI PR
00674
US

IV. Provider business mailing address

GARDEN HILLS SUR CALLE PALMA SOLA GA-13
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-0337
  • Fax:
Mailing address:
  • Phone: 787-362-5543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: EDUARDO PARTIDA RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-362-5543