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General NPI Number Information
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NPI Number | 1407197502
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Entity Type | Organization
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Legal Business Name | CPR CARDIO CARE, CSP
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 55 DE DIEGO CPR BUILDING SUITE 303-304
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City | MAYAGUEZ
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State | PR
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Zip | 00681
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Country | US
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Telephone | 787-833-6100
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Fax | 787-833-5980
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Provider Business Mailing Address
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Address Line | PO BOX 1522
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City | MAYAGUEZ
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State | PR
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Zip | 00681-1522
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Country | US
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Telephone | 787-833-6100
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Fax | 787-833-5980
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Authorized Official
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Title or Position | ASSISTANT
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Name | MISS JESSICA RODRIGUEZ MALDONADO
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Credential | BS
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Telephone | 787-310-9812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 7697
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License Number State | PR
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