Provider Demographics
NPI:1790338838
Name:CENTRO DE CARDIOLOGIA DE CAYEY LLC
Entity Type:Organization
Organization Name:CENTRO DE CARDIOLOGIA DE CAYEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANTOS ROALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-738-6444
Mailing Address - Street 1:PO BOX 372346
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-2346
Mailing Address - Country:US
Mailing Address - Phone:787-738-6444
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty