Provider Demographics
NPI:1417938978
Name:CARDIOVASCULAR ELECTRO PHYSIOLOGY PSC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ELECTRO PHYSIOLOGY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ABREU-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACC
Authorized Official - Phone:787-763-4494
Mailing Address - Street 1:PO BOX 363531
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3531
Mailing Address - Country:US
Mailing Address - Phone:787-763-4494
Mailing Address - Fax:787-765-7511
Practice Address - Street 1:735 PONCE DE LEON AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5023
Practice Address - Country:US
Practice Address - Phone:787-763-4494
Practice Address - Fax:787-765-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84888OtherTRIPLE S