Provider Demographics
NPI:1053650796
Name:METROPOLITAN CARDIOVASCULAR CSP
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOVASCULAR CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:NADAL
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-795-3557
Mailing Address - Street 1:PO BOX 2313
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2313
Mailing Address - Country:US
Mailing Address - Phone:787-795-3557
Mailing Address - Fax:
Practice Address - Street 1:SF15 CALLE AMALIA PAOLI
Practice Address - Street 2:7MA SECC LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3608
Practice Address - Country:US
Practice Address - Phone:787-795-3557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4847OtherLICENCE