Provider Demographics
NPI:1174638340
Name:CARDIO NEURO VASCULAR SERVICES, INC
Entity Type:Organization
Organization Name:CARDIO NEURO VASCULAR SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-4357
Mailing Address - Street 1:10-9 AVE NORTH MAIN
Mailing Address - Street 2:SIERRA BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4325
Mailing Address - Country:US
Mailing Address - Phone:787-787-4357
Mailing Address - Fax:787-787-4357
Practice Address - Street 1:10-9 AVE NORTH MAIN
Practice Address - Street 2:SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4325
Practice Address - Country:US
Practice Address - Phone:787-787-4357
Practice Address - Fax:787-787-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3305BOtherPREFERRED MEDICARE CHOICE
PR0021865Medicare ID - Type UnspecifiedPROVIDER NUMBER