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General NPI Number Information
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NPI Number | 1861838344
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY MEDICAL GROUP, CORP.
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 1820 AVE FERNANDEZ JUNCOS
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City | SAN JUAN
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State | PR
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Zip | 00909-3004
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Country | US
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Telephone | 787-960-1275
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Fax | 787-752-4818
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Provider Business Mailing Address
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Address Line | PO BOX 29744
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City | SAN JUAN
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State | PR
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Zip | 00929-0744
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Country | US
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Telephone | 787-960-1275
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Fax | 787-752-4818
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MRS. CARMEN J PAGAN DOMINGUEZ
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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