Provider Demographics
NPI:1235279308
Name:INSTITUTO CARDIOVASCULAR SAN FRANCISCO
Entity Type:Organization
Organization Name:INSTITUTO CARDIOVASCULAR SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-759-8159
Mailing Address - Street 1:PMB 444
Mailing Address - Street 2:P.O. BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-765-2312
Mailing Address - Fax:787-759-8159
Practice Address - Street 1:369 CALLE DE DIEGO
Practice Address - Street 2:SUITE 306
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-765-2312
Practice Address - Fax:787-759-8159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0080052Medicare ID - Type UnspecifiedPHYSICIANS