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General NPI Number Information
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NPI Number | 1235310533
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Entity Type | Organization
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Legal Business Name | CENTRO CARDIONUCLEAR DE GUAYAMA, CSP
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | CALLE 4 BLOQUE B 222 URB VIVES
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City | GUAYAMA
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State | PR
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Zip | 00785
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Country | US
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Telephone | 787-864-3370
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10007 SUITE 425
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City | GUAYAMA
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State | PR
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Zip | 00785
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Country | US
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Telephone | 787-864-3370
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE ACEVEDO
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Credential | M.D.
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Telephone | 787-864-3370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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