Provider Demographics
NPI:1942306410
Name:SERVICIOS CARDIOVASCULARES DEL OESTE, INC.
Entity Type:Organization
Organization Name:SERVICIOS CARDIOVASCULARES DEL OESTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-832-0995
Mailing Address - Street 1:125 ESTE CALLE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-832-0995
Mailing Address - Fax:787-831-2033
Practice Address - Street 1:125 ESTE CALLE DE DIEGO
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-0995
Practice Address - Fax:787-831-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Not Answered207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28300Medicaid
=========OtherEIN
PR28300Medicaid
28300Medicare UPIN