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NPI Code Detail

MEDICARE: SOUTHWEST CARDIOVASCULAR CARE GROUP, INC

MEDICARE: SOUTHWEST CARDIOVASCULAR CARE GROUP, INC
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
1261Q00000XClinic/Center13077PR
2261Q00000XClinic/Center13096PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11407831514OTHERPRNPI
21215970405OTHERNPI

General Provider Information

NPI Number : 1902218704
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST CARDIOVASCULAR CARE GROUP, INC
Provider Business Mailing Address
First Line : PO BOX 406
Second Line :
City : SAN GERMAN
State : PR
Zip : 00683-0406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8 CALLE JAVILLA
Second Line : PLAZA METROPOLITANA SUITE 104
City : SAN GERMAN
State : PR
Zip : 00683-4102
Country : US
Telephone Number : 787-892-4965
Fax Number : 787-264-2340
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID BERMUDEZ
Credential : MD
Telephone Number : 787-892-4965
Provider Enumeration Date : 05/28/2014
Last Update Date : 05/28/2014

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Directions to “SOUTHWEST CARDIOVASCULAR CARE GROUP, INC ” Practice Location

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