Provider Demographics
NPI:1093066318
Name:CARDIOLOGY ELITE, P.C.
Entity Type:Organization
Organization Name:CARDIOLOGY ELITE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-648-5779
Mailing Address - Street 1:PO BOX 600 SUITE 114N
Mailing Address - Street 2:MAYAGUEZ MEDICAL CENTER
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-648-5779
Mailing Address - Fax:787-648-5779
Practice Address - Street 1:AVE. HOSTOS #4410 SUITE 114N
Practice Address - Street 2:MAYAGUEZ MEDICAL CENTER
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-648-5779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16823207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16823OtherPR MEDICAL LICENSE