Provider Demographics
NPI:1316816010
Name:CARDIOCARE & VASCULAR GROUP, LLC
Entity type:Organization
Organization Name:CARDIOCARE & VASCULAR GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ ESCUDERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-723-5017
Mailing Address - Street 1:PO BOX 11577
Mailing Address - Street 2:FERNANDEZ JUNCOS STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-2677
Mailing Address - Country:US
Mailing Address - Phone:787-723-5017
Mailing Address - Fax:787-723-5015
Practice Address - Street 1:1492 AVE PONCE DE LEON
Practice Address - Street 2:EDIF CENTRO EUROPA SUITE 502
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-4024
Practice Address - Country:US
Practice Address - Phone:787-723-5017
Practice Address - Fax:787-723-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-31
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Multi-Specialty