Provider Demographics
NPI:1093846164
Name:GINEBRA CARDIOVASCULAR DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:GINEBRA CARDIOVASCULAR DIAGNOSTIC SERVICES
Other - Org Name:GCDS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GINEBRA VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-383-9005
Mailing Address - Street 1:M19 CALLE RUBI
Mailing Address - Street 2:URB. LA PLATA
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4873
Mailing Address - Country:US
Mailing Address - Phone:787-383-9005
Mailing Address - Fax:787-714-2308
Practice Address - Street 1:BO RINCO CARR 171 KM 4 HM4
Practice Address - Street 2:SEC NOGUERAS
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-383-9005
Practice Address - Fax:787-714-2308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities