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General NPI Number Information
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NPI Number | 1437409976
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Entity Type | Organization
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Legal Business Name | GRUPO MEDICO CARDIOVASCULAR-PY
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | GK29 AVE ROBERTO SANCHEZ VILELLA
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City | CAROLINA
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State | PR
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Zip | 00982-2657
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Country | US
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Telephone | 787-565-8179
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Fax |
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Provider Business Mailing Address
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Address Line | URB. EL COMANDANTE C/ ANTONIO LUCIANO 1238
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City | SAN JUAN
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State | PUERTO RICO
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Zip | 00924
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Country | UM
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Telephone | 787-565-8179
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. YANISLEY CRESPO LAHERA
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Credential |
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Telephone | 787-565-8179
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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 |
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License Number State |
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