Provider Demographics
NPI:1063272813
Name:ADVANCED HEART FAILURE OF PR LLC
Entity type:Organization
Organization Name:ADVANCED HEART FAILURE OF PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FABIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCI GORBEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-938-7014
Mailing Address - Street 1:PO BOX 4080
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-4080
Mailing Address - Country:US
Mailing Address - Phone:787-938-7014
Mailing Address - Fax:
Practice Address - Street 1:500 AVE DEGETAU
Practice Address - Street 2:HIMA PLAZA 1 SUITE 510
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Single Specialty