Provider Demographics
NPI:1477970044
Name:INSTITUTO METROPOLITANO DE CARDIOLOGIA
Entity Type:Organization
Organization Name:INSTITUTO METROPOLITANO DE CARDIOLOGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-787-8060
Mailing Address - Street 1:P O BOX 9432
Mailing Address - Street 2:BAYAMON BRANCH
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8043
Mailing Address - Country:US
Mailing Address - Phone:787-787-8060
Mailing Address - Fax:
Practice Address - Street 1:EDIF. DR. ARTURO CADILLA
Practice Address - Street 2:SUITE 207
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-787-8060
Practice Address - Fax:787-779-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2149207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77068Medicare UPIN