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General NPI Number Information
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NPI Number | 1861470932
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Entity Type | Organization
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Legal Business Name | CENTRO CARDIOVASCULAR DR MANUEL A QUILES LUGO CSP
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | CENTRO PLAZA BUILDING LLOVERAS ST SUITE 103
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-723-4555
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Fax | 787-721-5180
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Provider Business Mailing Address
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Address Line | PO BOX 19062
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City | SAN JUAN
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State | PR
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Zip | 00910-1062
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Country | US
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Telephone | 787-723-4555
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Fax | 787-721-5180
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANUEL A QUILES
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Credential | MD
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Telephone | 787-723-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8990
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 8990
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License Number State | PR
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