Provider Demographics
NPI:1518395375
Name:CENTRO DE PREVENCION DE ENFERMEDADES CARDIOVASCULARES
Entity Type:Organization
Organization Name:CENTRO DE PREVENCION DE ENFERMEDADES CARDIOVASCULARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:PORFIRIO
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:DIAZ-ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-810-4024
Mailing Address - Street 1:600 BLVD DE LA MONTANA APT 462
Mailing Address - Street 2:ARBOLES DE MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7121
Mailing Address - Country:US
Mailing Address - Phone:787-731-1066
Mailing Address - Fax:787-731-4632
Practice Address - Street 1:600 BLVD DE LA MONTANA APT 462
Practice Address - Street 2:ARBOLES DE MONTEHIEDRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7121
Practice Address - Country:US
Practice Address - Phone:787-731-1066
Practice Address - Fax:787-731-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty