Provider Demographics
NPI:1265862999
Name:ADVANCED ELECTROPHYSIOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCED ELECTROPHYSIOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZOLA CASTANER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-504-8868
Mailing Address - Street 1:501 METRO MEDICAL CENTER A
Mailing Address - Street 2:995 CARRETERA NUM. 2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 METRO MEDICAL CENTER A
Practice Address - Street 2:995 CARRETERA NUM 2
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-294-9039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14185207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1548278187OtherINDIVIDUAL NPI
PRI58868Medicare UPIN