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General NPI Number Information
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NPI Number | 1457526782
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Entity Type | Organization
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Legal Business Name | J.E.R.I. CARDIOMED, P.S.C.
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | N7 CALLE 18 URB OASIS GARDENS
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-766-0466
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Fax |
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Provider Business Mailing Address
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Address Line | N7 CALLE 18 URB OASIS GARDENS
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-766-0466
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE ENRIQUE RIVERA IRIZARRY
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Credential |
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Telephone | 787-766-0466
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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 | 12297
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License Number State | PR
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