Healthcare Provider Details

I. General information

NPI: 1386745651
Provider Name (Legal Business Name): EL SENORIAL CARDIOVASCULAR SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. EL CEREZAL CALLE PARANA #1716
SAN JUAN PR
00926
US

IV. Provider business mailing address

1716 CALLE PARANA EL CEREZAL
SAN JUAN PR
00926-3148
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-2200
  • Fax: 787-282-0483
Mailing address:
  • Phone: 787-766-2200
  • Fax: 787-282-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. AWILDA TOSADO
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-766-2200