Healthcare Provider Details

I. General information

NPI: 1811735194
Provider Name (Legal Business Name): CORLINK CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 CALLE FERNANDO CALDER # 220
SAN JUAN PR
00918-2769
US

IV. Provider business mailing address

463 CALLE FERNANDO CALDER # 220
SAN JUAN PR
00918-2769
US

V. Phone/Fax

Practice location:
  • Phone: 787-565-0127
  • Fax:
Mailing address:
  • Phone: 787-565-0127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL A BANOS
Title or Position: PRESIDENT
Credential:
Phone: 787-565-0127