Provider Demographics
NPI:1851427884
Name:HEART FAILURE CENTERS OF PUERTO RICO
Entity Type:Organization
Organization Name:HEART FAILURE CENTERS OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESUDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-637-3058
Mailing Address - Street 1:VILLA CAPARRA EXECUTIVE
Mailing Address - Street 2:229 CARR. #2 APT 15 F
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1944
Mailing Address - Country:US
Mailing Address - Phone:787-781-6539
Mailing Address - Fax:787-781-6539
Practice Address - Street 1:TORRE MEDICA I
Practice Address - Street 2:200 CARR. #2 SUITE 215
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-0508
Practice Address - Fax:787-884-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022606Medicare ID - Type Unspecified
NCH88500Medicare UPIN