Provider Demographics
NPI:1528165735
Name:AGUADILLA HEART CENTER INC
Entity type:Organization
Organization Name:AGUADILLA HEART CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTAN ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:ROLDAN
Authorized Official - Last Name:TIRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-819-1925
Mailing Address - Street 1:PO BOX 5261
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-5261
Mailing Address - Country:US
Mailing Address - Phone:787-819-1925
Mailing Address - Fax:787-819-1928
Practice Address - Street 1:HOSPITAL BUEN SAMARITANO
Practice Address - Street 2:AVE. SEVERIANO CUEVAS # 18
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-819-1925
Practice Address - Fax:787-819-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty