Healthcare Provider Details

I. General information

NPI: 1730411380
Provider Name (Legal Business Name): HEART RHYTHM MANAGEMENT PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AMERICO MIRANDA, ESQ CENTRO MEDICO CENTRO CARDIOVASCULAR DE PR, SUITE 10
RIO PIEDRAS PR
00924-0000
US

IV. Provider business mailing address

PO BOX 363047
SAN JUAN PR
00936-3047
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-4160
  • Fax: 787-763-4162
Mailing address:
  • Phone: 787-763-4160
  • Fax: 787-763-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number16026
License Number StatePR

VIII. Authorized Official

Name: DR. JUAN CARLOS SOTOMONTE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-763-4160