1659092732 NPI number — CARDIOVASCULAR IMAGING CENTER

Table of content: (NPI 1659092732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659092732 NPI number — CARDIOVASCULAR IMAGING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOVASCULAR IMAGING CENTER
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:
1659092732
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 191855
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00919-1855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-342-4736
Provider Business Mailing Address Fax Number:
877-736-2593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. #1 PLAZA BAIROA SUITE 120, AVE SAKURA
Provider Second Line Business Practice Location Address:
VILLA BLANCA INDUSTRIAL PARK
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-716-7272
Provider Business Practice Location Address Fax Number:
877-736-2593
Provider Enumeration Date:
09/07/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JIMENEZ-REYES
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
ELECTROPHYSIOLOGIST
Authorized Official Telephone Number:
787-633-4263

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207NS0135X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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