Provider Demographics
NPI: | 1346556925 |
---|---|
Name: | CARDIOVASCULAR RADIOLOGY INSTITUTE |
Entity type: | Organization |
Organization Name: | CARDIOVASCULAR RADIOLOGY INSTITUTE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | NYDIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RIVERA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 787-268-1015 |
Mailing Address - Street 1: | P.O. BOX 11792 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00910-2892 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-268-1015 |
Mailing Address - Fax: | 787-268-5511 |
Practice Address - Street 1: | CENTRO CARDIOVASCULAR DE P.R. Y EL CARIBE |
Practice Address - Street 2: | SUITE 1 |
Practice Address - City: | RIO PIEDRAS |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00926 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-753-1765 |
Practice Address - Fax: | 787-771-9182 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CARDIOVASCULAR RADIOLOGY INSTITUTE |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2010-08-20 |
Last Update Date: | 2010-08-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |