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General NPI Number Information
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NPI Number | 1558080499
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Entity Type | Organization
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Legal Business Name | SAN JUAN CARDIOLOGY LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | AVE. PONCE DE LEON #715, PARADA 37 1/2
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-758-2000
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Fax |
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Provider Business Mailing Address
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Address Line | MIRAMONTE 15, GARDEN HILLS TOWER 603
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-309-8015
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEJANDRO ANDRES QUILICHINI OLIVER
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Credential | MD
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Telephone | 787-309-8015
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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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