Provider Demographics
NPI:1992340038
Name:CV MED LLC
Entity type:Organization
Organization Name:CV MED LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMILO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-732-0566
Mailing Address - Street 1:PO BOX 1149
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-1149
Mailing Address - Country:US
Mailing Address - Phone:787-732-0753
Mailing Address - Fax:787-712-3027
Practice Address - Street 1:41 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703-3233
Practice Address - Country:US
Practice Address - Phone:787-732-0753
Practice Address - Fax:787-712-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center