Provider Demographics
NPI:1922060508
Name:ANGEL'S CARDIOVASCULAR SERVICE, INC.
Entity Type:Organization
Organization Name:ANGEL'S CARDIOVASCULAR SERVICE, INC.
Other - Org Name:ANGEL'S CARDIOVASCULAR SERVICE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:PROF
Authorized Official - First Name:NATACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOZA
Authorized Official - Suffix:
Authorized Official - Credentials:TEC CARDIOVASCULAR
Authorized Official - Phone:787-403-0237
Mailing Address - Street 1:P.O BOX 193994
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3994
Mailing Address - Country:US
Mailing Address - Phone:787-403-0237
Mailing Address - Fax:787-764-7099
Practice Address - Street 1:690 CALLE CESAR GLEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3902
Practice Address - Country:US
Practice Address - Phone:787-403-0237
Practice Address - Fax:787-764-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057232Medicare ID - Type UnspecifiedANGEL'S CARDIOVASCULAR