Provider Demographics
NPI:1730310483
Name:CENTRO CARDIOVASCULAR BAIROA C.S.P.
Entity Type:Organization
Organization Name:CENTRO CARDIOVASCULAR BAIROA C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-745-4665
Mailing Address - Street 1:CALLE REINA ISABEL URB. BAIROA
Mailing Address - Street 2:AB6
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-745-4665
Mailing Address - Fax:787-743-0177
Practice Address - Street 1:URB. BAIROA ST. REINA ISABEL
Practice Address - Street 2:AB6
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-4665
Practice Address - Fax:787-743-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12189207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty