Provider Demographics
NPI:1356860357
Name:PUERTO RICO CARDIAC ARRHYTHMIA MANAGEMENT LLC
Entity Type:Organization
Organization Name:PUERTO RICO CARDIAC ARRHYTHMIA MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARCIAL SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-461-1174
Mailing Address - Street 1:404 AVE DE LA CONSTITUCION APT 901
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2247
Mailing Address - Country:US
Mailing Address - Phone:787-461-1174
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO MENONITA DE CAYEY
Practice Address - Street 2:EDIFICIO PROFESIONAL SUITE 410
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-388-9001
Practice Address - Fax:787-738-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20760207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty