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General NPI Number Information
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NPI Number | 1649306085
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Entity Type | Organization
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Legal Business Name | DR. JORDAN CARDIOLOGY CENTER
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 1814 AVE FERNANDEZ JUNCOS
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City | SAN JUAN
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State | PR
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Zip | 00909-3001
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Country | US
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Telephone | 787-728-7083
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Fax | 787-728-3366
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Provider Business Mailing Address
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Address Line | PO BOX 11689
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City | SAN JUAN
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State | PR
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Zip | 00910-2789
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Country | US
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Telephone | 787-728-7083
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Fax | 787-728-3366
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDMUNDO J JORDAN-MOREY
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Credential | MD
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Telephone | 787-728-7083
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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 | 13273
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License Number State | PR
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