Healthcare Provider Details

I. General information

NPI: 1417938978
Provider Name (Legal Business Name): CARDIOVASCULAR ELECTRO PHYSIOLOGY PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 PONCE DE LEON AVE SUITE 805
SAN JUAN PR
00917-5023
US

IV. Provider business mailing address

PO BOX 363531
SAN JUAN PR
00936-3531
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-4494
  • Fax: 787-765-7511
Mailing address:
  • Phone: 787-763-4494
  • Fax: 787-765-7511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MIGUEL E ABREU-GARCIA
Title or Position: OWNER
Credential: MD FACC
Phone: 787-763-4494