Healthcare Provider Details

I. General information

NPI: 1619353869
Provider Name (Legal Business Name): ERICA OTERO CARDENAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/01/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO CARDIOVASCULAR DE PUERTO RICO Y DEL CARIBE FIRST FLOOR, SUITE 6
SAN JUAN PR
00935
US

IV. Provider business mailing address

LOMAS DEL MANATUABON 136 CALLE YUISA, MANATI, PUERTO RICO
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-425-0168
  • Fax:
Mailing address:
  • Phone: 787-754-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number21771
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: