Provider Demographics
NPI:1912047986
Name:CARDIOVASCULAR INTERVENTIONAL THERAPEUTICS M D P S C
Entity type:Organization
Organization Name:CARDIOVASCULAR INTERVENTIONAL THERAPEUTICS M D P S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:O
Authorized Official - Last Name:DAVILA RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-378-7827
Mailing Address - Street 1:PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-754-8500
Mailing Address - Fax:787-763-2772
Practice Address - Street 1:CENTRO CARDIOVASCULAR DE PR Y DEL CARIBE
Practice Address - Street 2:SUITE NUM 9
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-8344
Practice Address - Country:US
Practice Address - Phone:787-754-8500
Practice Address - Fax:787-763-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty