Healthcare Provider Details

I. General information

NPI: 1346556925
Provider Name (Legal Business Name): CARDIOVASCULAR RADIOLOGY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO CARDIOVASCULAR DE P.R. Y EL CARIBE SUITE 1
RIO PIEDRAS PR
00926
US

IV. Provider business mailing address

P.O. BOX 11792
SAN JUAN PR
00910-2892
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-1765
  • Fax: 787-771-9182
Mailing address:
  • Phone: 787-268-1015
  • Fax: 787-268-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NYDIA RIVERA
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-268-1015