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General NPI Number Information
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NPI Number | 1043477995
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Entity Type | Organization
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Legal Business Name | CENTRO CARDIOVASCULAR DE CAROLINA I
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 4A S3 ANEXO PISO 2 FRAGOSO AVE
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City | CAROLINA
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State | PR
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Zip | 00984
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Country | US
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Telephone | 787-757-0825
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Fax | 787-762-2730
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Provider Business Mailing Address
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Address Line | PO BOX 2250
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City | RIO GRANDE
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State | PR
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Zip | 00745-2239
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Country | US
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Telephone | 787-757-0620
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Fax | 787-762-2730
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERTO R FRED SANTANA
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Credential | MD
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Telephone | 787-757-0825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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