1235279308 NPI number — INSTITUTO CARDIOVASCULAR SAN FRANCISCO

Table of content: HANNAH MARIE VAIDEN RN (NPI 1366352072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235279308 NPI number — INSTITUTO CARDIOVASCULAR SAN FRANCISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTO CARDIOVASCULAR SAN FRANCISCO
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:
1235279308
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB 444
Provider Second Line Business Mailing Address:
P.O. BOX 70344
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-8344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-765-2312
Provider Business Mailing Address Fax Number:
787-759-8159

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 CALLE DE DIEGO
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00923-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-765-2312
Provider Business Practice Location Address Fax Number:
787-759-8159
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEREA
Authorized Official First Name:
RAMON
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-759-8159

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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