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General NPI Number Information
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NPI Number | 1801007794
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR MEDICAL DIAGNOSTIC SERVICES
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | URB. BERWIND ESTATES CALLE 17 T-9
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-752-4818
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Fax | 787-752-4818
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Provider Business Mailing Address
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Address Line | URB. BERWIND ESTATES CALLE 17 T-9
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-752-4818
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Fax | 787-752-4818
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Authorized Official
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Title or Position | PRESIDENTA
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Name | MRS. CARMEN JUDITH PAGAN
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Credential |
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Telephone | 787-960-1275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | 3878
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License Number State | PR
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