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General NPI Number Information
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NPI Number | 1447675137
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Entity Type | Organization
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Legal Business Name | PCI GROUP
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | CALLE DE DIEGO APT 21 474 DE DIEGO CHALETS
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-486-5375
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE DE DIEGO APT 21 474 DE DIEGO CHALETS
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-486-5375
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Fax |
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Authorized Official
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Title or Position | INTERVENTIONAL CARDIOLOGIST
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Name | VALENTIN J DEL RIO SANTIAGO
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Credential | M.D.
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Telephone | 787-486-5375
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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 | 17655
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 17771
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License Number State | PR
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