Provider Demographics
NPI:1073921292
Name:INSTITUTO CARDIOVASCULAR DE CAROLINA
Entity Type:Organization
Organization Name:INSTITUTO CARDIOVASCULAR DE CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:VINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-757-8780
Mailing Address - Street 1:267 CALLE SIERRA MORENA
Mailing Address - Street 2:PMB 80
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5574
Mailing Address - Country:US
Mailing Address - Phone:787-757-8780
Mailing Address - Fax:787-276-9174
Practice Address - Street 1:4AS1 VIA LETICIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4801
Practice Address - Country:US
Practice Address - Phone:787-757-8780
Practice Address - Fax:787-276-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6527261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty