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General NPI Number Information
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NPI Number | 1992340038
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Entity Type | Organization
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Legal Business Name | CV MED LLC
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 41 CALLE MUNOZ RIVERA
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-3233
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Country | US
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Telephone | 787-732-0753
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Fax | 787-712-3027
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Provider Business Mailing Address
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Address Line | PO BOX 1149
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-1149
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Country | US
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Telephone | 787-732-0753
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Fax | 787-712-3027
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN CAMILO
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Credential | MD
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Telephone | 787-732-0566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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