Provider Demographics
NPI:1497997555
Name:GASTROENTEROLOGY AND CARDIAC ARRHYTHMIA SERVICE PSC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY AND CARDIAC ARRHYTHMIA SERVICE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUARDE
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-390-9090
Mailing Address - Street 1:93 PASEO HERRADURA
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6068
Mailing Address - Country:US
Mailing Address - Phone:787-390-9090
Mailing Address - Fax:
Practice Address - Street 1:93 PASEO HERRADURA
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6068
Practice Address - Country:US
Practice Address - Phone:787-390-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13,964207RC0001X
PR15,987207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty