1962118190 NPI number — HEART FAILURE CARE LLC

Table of content: JOSEPHINE SANTIAGO SAMSON LPN (NPI 1467737981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962118190 NPI number — HEART FAILURE CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART FAILURE CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962118190
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COND PINE GROVE
Provider Second Line Business Mailing Address:
B6 AVE ISLA VERDE APT 46A
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00979-7128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-409-7788
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE JOSE CELSO BARBOSA BO MONACILLO
Provider Second Line Business Practice Location Address:
CENTRO CARDIOVASCULAR DE PR Y CARIBE 1ER PISO SUITE 3
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-679-8800
Provider Business Practice Location Address Fax Number:
787-767-8800
Provider Enumeration Date:
01/31/2023

Additional Information

Authorized Official

Authorized Official Last Name:
PUIG CARRION
Authorized Official First Name:
GISELA
Authorized Official Middle Name:
DENISE
Authorized Official Title or Position:
MD, OWNER
Authorized Official Telephone Number:
787-409-7788

Provider Taxonomy Codes

  • Taxonomy code: 207RA0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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