MEDICARE: CAGUAS CARDIO IMAGING GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		PR

General Provider Information

NPI Number	:	1285705277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAGUAS CARDIO IMAGING GROUP

Provider Business Mailing Address
First Line	:	200 AVE RAFAEL CORDERO PMB 482
Second Line	:	SUITE 140
City	:	CAGUAS
State	:	PR
Zip	:	00725-3740
Country	:	US
Telephone Number	:	787-258-6551
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR # 52 BO CANABON OFIC 208
Second Line	:	200 AVE RAFAEL CORDERO PMB 482
City	:	CAGUAS
State	:	PR
Zip	:	00725-3757
Country	:	US
Telephone Number	:	787-747-6045
Fax Number	:

Authorized Official
Title or Position	:	CARDILOGO
Name	:	DR. JESUS M SANTOS
Credential	:	MD
Telephone Number	:	787-747-6045

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/21/2022

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