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General NPI Number Information
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NPI Number | 1558509224
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Entity Type | Organization
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Legal Business Name | ADVANCED CARDIO-SURGICAL GROUP, INC.
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 2225 PONCE BY PASS EDIF PARRA SUITE 905
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-844-2710
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Fax | 787-844-2832
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Provider Business Mailing Address
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Address Line | P O BOX 331788
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City | PONCE
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State | PR
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Zip | 00733-1788
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Country | US
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Telephone | 787-844-2710
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Fax | 787-844-2832
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. CARLOS J CARRO
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Credential | M.D.
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Telephone | 787-844-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 6958
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License Number State | PR
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