Provider Demographics
NPI:1083647382
Name:SE CARDIOLOGY EXPERTS PSC
Entity Type:Organization
Organization Name:SE CARDIOLOGY EXPERTS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTOS-ELOSEGUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-737-7176
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-737-7176
Mailing Address - Fax:787-737-1226
Practice Address - Street 1:SAN JOSE #52
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-737-7176
Practice Address - Fax:787-737-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13402207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty