1851427884 NPI number — HEART FAILURE CENTERS OF PUERTO RICO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851427884 NPI number — HEART FAILURE CENTERS OF PUERTO RICO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART FAILURE CENTERS OF PUERTO RICO
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:
1851427884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VILLA CAPARRA EXECUTIVE
Provider Second Line Business Mailing Address:
229 CARR. #2 APT 15 F
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966-1944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-781-6539
Provider Business Mailing Address Fax Number:
787-781-6539

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TORRE MEDICA I
Provider Second Line Business Practice Location Address:
200 CARR. #2 SUITE 215
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-884-0508
Provider Business Practice Location Address Fax Number:
787-884-0512
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRAGIN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESUDENT
Authorized Official Telephone Number:
787-637-3058

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  13200 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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